Experimental Therapy May Treat Depression

A new experimental therapy used to treat depression showed promising results in a new study published in the Journal of American Medicine Psychiatry. The new treatment stimulates the brain with a mild electrical current, using only 1/400th the charge of electroconvulsive therapy (ECT). What's more, it appears to achieve similar results without such side effects as memory problems.

The study looked at 120 patients with major depressive disorder who were not previously on antidepressants. It's the largest study of its type to date and the first to compare the new treatment with antidepressant medication.

Researchers compared this new treatment, called transcranial direct current stimulation, or tDCS, with the antidepressant drug sertraline (Zoloft). The treatment was found to be as effective as a low dose of Zoloft. Combining the two treatments saw better results than did each treatment used separately.

After six weeks, researchers looked at changes in the Montgomery-Asberg Depression Rating Scale—a questionnaire designed to measure the severity of depressive episodes—and found a clinically significant difference 

ECT is safer, but side effects remain.

Although both ECT (also known as electroshock therapy) and tDCS involve electricity, they are distinctly different treatments.

ECT consists of passing electrical currents through the brain in a process that creates changes in brain chemistry. It is often effective in treating mental illness, even when other treatments don’t work.

ECT has developed a bad rap historically. Earlier treatments often caused seizures and fractured bones. However, electroshock therapy these days looks much different than it did in One Flew Over the Cuckoo’s Nest. The treatment has become much safer, due in no small part to the use of anesthesia.

However, memory loss remains a problematic side effect of ECT. Patients may have difficulty remembering events that took place before treatment, during the treatment, and sometimes even after the treatment has ended. Memory problems, though, usually improve within several months.

Risks of ECT also include heart rate and blood pressure increases. In rare cases, this may lead to heart problems.

How is tDCS different?

While ECT often lasts only seconds under anesthesia, tDCS can take 20 to 30 minutes, and the patients are fully conscious. That’s because transcranial direct current simulation, which entails placing two electrodes on the patient’s temples, uses only a fraction of the electrical current that is used in ECT. Additionally, tDCS runs on a battery and can be carried around, making it more portable and convenient.

Although it is showing promise as a treatment for depression, tDCS was originally developed to help patients with brain injuries and strokes. The therapy helped to improve their problem-solving ability, memory, attention, and even math and language skills.

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Medical researchers from the University of South Wales and the Black Dog Institute previously completed a study in 2012 that showed 20 minutes of tDCS every day for up to six weeks is a safe and effective treatment for depression. This research was conducted on 64 participants who did not benefit from other depression treatments. In addition, the study showed that the treatment had other benefits, such as improved attention and even relief from chronic neck pain.

“We think that is because tDCS actually changes the brain’s perception of pain,” Professor Loo, who worked on the study, stated in a press release.

There were some side effects of tDCS treatment. Redness at the site of the treatment (on the scalp) was one such side effect, and there appeared to be an increased risk for manic episodes.

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Will tDCS replace ECT or antidepressants?

Although it’s too soon to state definitively, doctors are already speculating on the possibility. “I think tDCS could be tried before ECT,” or for “avoiding drug treatment in patients that cannot use drugs,” study author Dr. Andre R. Brunoni told the New York Times.

This might include patients who are pregnant and cannot safely take antidepressants or those who haven’t responded to the drugs, for example. However, the research did show that the combination of the antidepressant and tDCS were most effective when used together.

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