Healthy Aging: Body, Mind & Spirit

New electronic products effective in treating severe depression, anxiety, SAD and insomnia

Physicians have known for 2,000 years that electricity could help troubled minds, and today there’s a growing consensus among neuroscientists that many psychiatric illnesses stem from problems in the brain’s electrical circuits.   “In psychiatry, we have gone from ‘It’s all about your mother’ a la Freud to the concept of chemical imbalances in the brain to the current focus on dysfunctional brain circuits and genetics,” says Emory University neurologist Helen Mayberg, a pioneer in brain imaging and depression.

Take for example electroconvulsive therapy (ECT), the decades-old practice of using electric current to trigger a brief brain seizure.   “The reason we still have ECT is that we need it.  It’s the most rapidly acting and effective approved treatment we have for major depression,” says Duke University Medical Center psychiatry chairwoman Sarah Lisanby, one of many who fear that suicides might rise if ECT were unavailable.    Once known for blunting personalities and breaking bones, ECT has become much safer in recent years.   Patients now undergo general anesthesia, the current is far more controlled and it is often applied only on one side to minimize memory loss.  More than 100,000 ECT procedures are conducted annually in the U.S.

Meanwhile, another older technology is getting new attention.  Cranial Electrotherapy Stimulation (CES), which sends very weak micro-currents into the brain, was widely used in Russia in the 1940s as a sleep aid.   Several battery-powered CES devices won FDA clearance to treat depression, anxiety and insomnia in the 1980s and 1990s, largely because they were similar to other grandfathered devices, and some have been quietly selling to home users ever since.

Last fall, a newcomer in the field, Fisher Wallace Laboratories, launched a YouTube campaign lampooning the side effects of anti-depressants and promoting its cranial stimulator as a practical alternative.   Powered by two AA batteries, the device sends 1 milliampere of alternating current—1/1,000th the voltage used in ECT—through a patient’s head via small, wet pads placed at the temples.   The company recommends using the device 20 minutes once or twice a day for 30 to 45 days, and several times a week afterward.

The company, founded by electronics entrepreneur Charles Avery Fisher and Martin Wallace in 2007, says the device works by boosting endorphins, serotonin and dopamine and reducing cortisol

Does it work?   Columbia University psychiatrist Richard P. Brown says he has used the device with 400 severely depressed patients and that more than 70% found relief—about twice the rate of anti-depressants.   “I’m seeing some patients smile for the first time in 20 years,” says Dr. Brown, who, like other doctors interviewed for this column, have no financial ties to the company.

Much of the clinical data supporting CES devices is outdated; a few small placebo-controlled trials of the Fisher Wallace device are planned at Harvard, Columbia and the University of Toledo.

“I think a lot of people who use it will tell you it can be very helpful, but I am looking forward to the double-blind placebo-controlled trials,” says Andres San Martin, a Columbia psycho-pharmacologist who says about 50 of his patients use the device, along with antidepressants.   Some use it just half the year for Seasonal Affective Disorder, while others have found it helpful in quitting smoking or for insomnia caused by menopause.

This post was created with excerpts from this Wall Street Journal article dated January 11, 2011.