Transcranial Direct Current Stimulation (tDCS)

What is Transcranial Direct Current Stimulation?

Transcranial Direct Current Stimulation or tDCS is an emerging evidence-based brain stimulation therapy used in the treatment of depression. The treatment involves the introduction of a small electrical current to raise the resting membrane potential and thus the excitability of the neurons in the stimulated brain area and interconnected areas. Of the numerous other types of brain stimulation therapies under investigation, transcranial direct current stimulation has repeatedly demonstrated benefits in the treatment of Depression. Some studies have shown beneficial effects in the treatment of Fibromyalgia, Pain, Addiction and related disorders. Unlike most other neurostimulation therapies, as the tDCS machine is portable, treatment can occur in an outpatient setting or even at home once the patient is comfortable operating the device on their own. As the brain areas involved in the regulation of mood are interconnected, stimulation of one area of the brain, positively impacts all other interconnected areas. Through repetitive stimulation with tDCS over a typical acute course daily over 4 weeks, we can achieve excellent results in the treatment of depression. There are no cognitive side effects with tDCS unlike Electroconvulsive Therapy (ECT). In fact, there are several studies reporting cognitive benefits with tDCS. The patient is fully alert and conscious throughout the procedure. Also, as this involves stimulation of specific areas of the brain, the rest of the body is not exposed to the effects of the treatment unlike medications which can cause unwanted effects in other areas of the body.

Benefits of tDCS

  • It is an effective treatment for depression that can be used as an alternative or complement to antidepressant medication and psychological therapy.

  • It is well tolerated.

  • Most side effects are very mild and easily managed if they occur.

  • There are no cognitive side effects and there may even be cognitive benefits.

  • No sedation is required.

  • The treatment is non-invasive.

  • Treatment can occur at home.

Side Effects of tDCS

  • Mild Headache

  • Localised heat and skin irritation at the site of treatment
    These side effects are usually a function of incorrect electrode placement and not being used to the nature of the treatment. These are usually resolved within the first few sessions if they do occur.

  • Seizures (extremely rare)
    The rare side effects usually occur in people who are already vulnerable to these conditions 

Who is tDCS for?

You may benefit from Transcranial Direct Current Stimulation if you are suffering from depression and wish to try an alternative or an adjunctive form of treatment to antidepressant medications or psychological therapy. tDCS may be beneficial for those who wish to receive treatment in an outpatient setting or at home. As a safety precaution, tDCS is not available for people who have intracranial implants, those with epilepsy and other neurological disorders, and those with pacemakers. Thus far, there have been no significant safety concerns with those under 18 or with pregnant women but we are cautious in the use of tDCS in these groups.

How to access tDCS?

We suggest that patients are assessed by their general practitioner or psychiatrist first in relation to their mental and/or other illnesses, and then referred to a tDCS trained psychiatrist for consideration of treatment. If the referral is accepted, the patient is then assessed in relation to their suitability for tDCS treatment. If suitable, a further session is organised where the patient is coached on the use of the tDCS machine. If comfortable, the patient can then take the machine home for treatment over 4 weeks, with weekly follow up reviews in clinic. Antidepressant and other medications can be continued during the tDCS treatment if needed, and patients can and should continue to attend available individual and group psychological therapy.

How to see Dr Vijay Raj?

If you are concerned that either you or a loved one is troubled by a mental illness, please request a GP assessment. The GP can then refer to Dr Raj for further support as needed. The referral is then reviewed, and if appropriate, an appointment can be organised for the initial consult. Consults for Autism and ADHD assessments will require a few appointments for the assessments to be completed. Depending on the complexity, this may also be the case for other conditions as well. Waiting times and fees can be clarified with the practice where the consult is to occur.