The Fisher-Wallace Stimulator

Recently I convinced a patient to buy and use one of these:

She had to pay about 700 dollars cash for it.

I had her on a variety of antidepressants and anti-anxiety drugs, and she had survived untold numbers of similar drugs from the three or so psychiatrists she saw before me. She assured me none of them had been much help.

I think a couple of psychiatrists before me had addicted her to some drugs. We are trying to get her off them slowly and reasonably. I can understand why she felt poorly without them, for she had been addicted to them quite effectively without knowing she was.

There are two over-the-counter (no Rx needed) electrical stimulation devices for anxiety insomnia, and depression that are now on the market. The other is the Alpha-Stim, which also claims to help with pain.

https://www.alpha-stim.com/healthcare-professionals/research-and-reports/

The two don’t seem to be all that different in terms of price or mechanism.

Electrotherapy is back. I am one of a few who is old enough to have been trained in ECT (electroconvulsive therapy) when it was popular. Side effects like some memory loss, not necessarily completely reversible, as a well as a general fear of having electricity applied to the head, have made it become unpopular.

Now we have Transcranial Magnetic Stimulation (TMS) — endorsed by many insurance companies — but with statistics for efficacy which I find fairly disappointing.

In the studies, people who have both medication and electro-stimulation seem to do better than those with only one of the other, so I recommend them only when I don’t really believe we are getting enough effective symptom relief from a single medication at the FDA max. Usually I present it as a patient choice — using an apparatus (if they can afford the $700) or adding another medication to (hopefully) augment antidepressant efficacy.

The patient I described above is doing so lovely she wanted to dump a lower dose (not an FDA approved maximum dose) because it caused a tremor.

Now she says things are better and she doesn’t think she even needs an antidepressant anymore.

This is the place where making inferences for “objective” research reports just doesn’t tell you what to do with a patient.

You have to review advantages and risks.

There is no reason that an electric brain stimulating apparatus cannot be used together with medications. I have done this before. The worst side effect of cranial stimulation in this manner seems to be skin discomfort beneath the electrodes, which I as patients to report to me if they get which they never seem to.

The idea is to individualize treatment to the patient.

Pharmaceutical research is dependent upon large numbers of people responding to the same or similar doses of drugs.

Patients have different needs, so their diagnoses and presentation have different aspects.

You deserve individualized treatment from your psychiatrist.

Expect nothing less.