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Use of transcranial current stimulation weakly supported for psychiatry

A recent review article indicated that evidence is lacking for the use of low-intensity transcranial current stimulation in psychiatry.

“Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials,” Noah S. Philip, MD, of Alpert Medical School of Brown University, and colleagues wrote. “In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices.”

To inform clinicians, researchers reviewed existing literature for devices and modalities that use low-energy electrical current for brain stimulation.

Current research supports the use of transcranial direct current stimulation (tDCS) for major depression. However, tDCS devices have not been approved for treating medical disorders and evidence is significantly inconclusive for other therapeutic areas, according to researchers.

Further, they found low-quality evidence for the use of cranial electrotherapy stimulation devices, which are the only category of tCS devices approved for psychiatric disorder.

“At this time, enthusiasm for tCS in clinical practice settings should be mitigated by the fact that there are no tDCS devices with FDA clearance for treatment of psychiatric disorders,” the researchers wrote. “Devices cleared for other indications (eg, iontophoresis) were utilized in some clinical tDCS studies, while other trials used devices that are only available for purchase and use in research protocols. Translating the tDCS literature into guidelines for tCS in clinical practice is thus complex. Further, tCS devices that do have FDA clearance (eg, CES devices manufactured by Fisher-Wallace, Alpha-Stim) either have not shown efficacy in recent published trials or have only limited support arising from low-quality data.” – by Amanda Oldt

Disclosure: Philip reports receiving research equipment and/or clinical trials contract (research grant) support from Neuronetics, Cervel Neurotech, and Neosync. Please see the study for a full list of relevant financial disclosures.