Major depressive disorder is a debilitating mental illness experienced by about 7% of US adults. Multiple treatment options exist for depression, including medication and various types of brain stimulation. However, every patient’s depression is different, and many are caused by different factors that may not respond to medication or even different types of brain stimulation. A relatively new brain stimulation treatment that has shown efficacy in many research studies in treatment-resistant patients is TDCS.
What is TDCS?
Transcranial direct current stimulation (TDCS) is a safe, non-invasive, well-tolerated brain-stimulation technique. Unlike transcranial magnetic stimulation (TMS), which uses magnetic fields to stimulate the brain, TDCS uses electrical currents. TDCS is not currently FDA approved.
What is the TDCS treatment process like?
TDCS is very easy to administer. The machine is powered by a 9-volt battery, which is the same that is used for home fire alarms. The electrodes are placed in sponges soaked in saline, which are then placed over certain parts of the head (for depression, the anode is placed over the left DLPFC) and kept in place using a rubber headband. Patients may feel a tingling or itching in the scalp during treatment, but these effects are minor.
At Houston Mind and Brain, TDCS will be administered for 20 minutes, twice a day, five days a week, for two weeks. If the patient is showing improvement, the treatment will be continued. Additionally, if there is a positive clinical outcome, there will be the option to receive at-home, self-administered TDCS treatments. We believe that this is the future of neurostimulation treatments for depression – after proper training, patients will be able to continue to administer their treatment in the comfort of their own home and only come into the clinic for periodic checks.
Why TDCS?
TDCS has about the same efficacy as antidepressant medication. However, TDCS is localized instead of impacting the entire body and brain as medications do, so TDCS has nearly no side effects. The more prevalent TMS has a slight risk of seizures, but TDCS does not. TDCS is most effective when patients are not on medication, so if you are unable to tolerate antidepressants or do not want to take them, TDCS may be the right treatment for you.
Additionally, many patients do not meet the insurance criteria for TMS and thus have to pay out of pocket. TDCS is not FDA approved and is not covered by insurance. However, this makes TDCS more accessible, and it is cheaper than TMS.
Want to know if TDCS is right for you?
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