Trans-cranial direct current stimulation (tDCS) based depression treatment is now also available in Helsinki.

Help for Depression from Tuuma Clinic

Treat­ment based on transc­ra­nial direct cur­rent sti­mu­la­tion (tDCS) is most effec­ti­ve in the symp­toms of acu­te depres­sion. Anxie­ty, a com­mon symp­tom of depres­sion, is often relie­ved during treat­ment. In addi­tion to inc­rea­sing acti­vi­ty and mood, treat­ment has often had a posi­ti­ve effect on sleep qua­li­ty.

Treat­ment with tDCS may be eit­her an alter­na­ti­ve to or sup­port for the drug treat­ment. Treat­ment can be star­ted to sup­port the reduc­tion of medica­tion and is also well sui­ted for someo­ne who is unwil­ling to take medica­tion, for example because of seve­re side effects or life circums­tances.

The effect of repea­ted treat­ments has been shown to per­sist for at least one month after the end of the treat­ment period1. The dura­tion of the effect can be exten­ded or enhanced with fol­low-up treat­ment2. A refer­ral from a psyc­hiat­rist is requi­red for treat­ment at the Tuu­ma Cli­nic.

tDCS — an effective method of treating depression

tDCS has been found to be an effec­ti­ve met­hod of trea­ting depres­sion, both wit­hout other treat­ments and in com­bi­na­tion with medica­tion or the­ra­py. Recent stu­dies show that the effect of tDCS treat­ment is simi­lar to anti­depres­sant medica­tion and rTMS (repea­ted transc­ra­nial mag­ne­tic sti­mu­la­tion)3,4.

tDCS treat­ment is men­tio­ned in the recent­ly (Jan 2020) upda­ted natio­nal Fin­nish cur­rent care gui­de­li­nes for the treat­ment of depres­sion.

61% of Soo­ma tDCS ‑trea­ted patients have recei­ved sig­ni­ficant relief from depres­si­ve symp­toms5. Many have said that after treat­ment they are more ener­ge­tic and proac­ti­ve than befo­re treat­ment. Many also men­tion that they sleep bet­ter after the treat­ment period.

A psyc­hiat­ric specia­list may refer you to a depres­sion treat­ment to the Tuu­ma Cli­nic. If your doc­tor is not yet awa­re of tDCS treat­ment, you can sug­gest it your­self. From the link below find a down­loa­dable info docu­ment of tDCS treat­ment, which can be used to sup­port deci­sion making.

Sooma tDCS is safe

The Soo­ma tDCS treat­ments can be done safe­ly at home. The easy-to-use Soo­ma tDCS Treat­ment Device (pic­tu­red below) has one but­ton to start and stop the treat­ment. The Soo­ma cap used in the treat­ments ensu­res that in all of the treat­ment ses­sions the trea­ted area is same.

Depres­sion has been found to cause chan­ges in brain func­tion, par­ticu­lar­ly in the fron­tal lobe. With tDCS, the symp­toms of depres­sion are cont­rol­led by con­duc­ting a weak elect­rical cur­rent (2 mA) between two elect­ro­des. Elect­ric cur­rent causes chan­ges in the acti­vi­ty of ner­ve cells in the brain. With repe­ti­ti­ve treat­ments, the effects also extend to the long-term func­tio­ning of ner­ve cells.

tDCS is a pain­less treat­ment with mild side effects that are tran­sient and local. During a treat­ment ses­sion, a slight tingling sen­sa­tion may appear at the elect­ro­des, and the skin under the elect­ro­des may be slight­ly red after the treat­ment. After the first couple of treat­ments can occur a mild hea­dac­he, which usual­ly disap­pears wit­hin half an hour.

The treatment can speed up the response of pharmaceutical
treatments and help with anxiety symptoms present alongside depression
.”

Kai­ja Jär­ven­taus­ta, Medical Doc­tor and Psyc­hiat­rist,
Pihlajalinna/Koskikeskus, Tam­pe­re

Treatment period for the symptoms of depression 

  • The treat­ment period is six weeks
  • The period inclu­des 30 ses­sions

Treat­ment of depres­sion with tDCS has often been stu­died over a three-week treat­ment period, which has gene­ral­ly inclu­ded 15 ses­sions. Stu­dies and expe­rience with treat­ment have shown that the effect of tDCS treat­ment on symp­toms and well-being is gene­ral­ly noticeable during or short­ly after the third week of treat­ment.

The treat­ment period in Tuu­ma is now six weeks to boost the effect of the treat­ment. A lon­ger treat­ment period also impro­ves the chances of achie­ving a the­ra­peu­tic effect. In addi­tion, a lon­ger period makes it easier to dis­tin­guish the effect of treat­ment from inter­mit­tent epi­so­des of bet­ter mood. This makes it easier to deci­de on the use­ful­ness of fol­low-up care.

The Soo­ma tDCS device used in Tuu­ma Cli­nic treat­ments is bor­rowed for the dura­tion of the treat­ment period, and almost all of the treat­ments are done at home. At the start of this period, the Tuu­ma nur­se will gui­de you through the treat­ment and the use of device. The first treat­ment is done gui­ded with the nur­se.

During one week of treat­ment, sti­mu­la­tion for 30 minu­tes is per­for­med for five con­secu­ti­ve days, fol­lowed by a two-day break after each week. The effect of tDCS treat­ment is indi­vi­dual. The effect is usual­ly noticeable towards or after the end of the third week of treat­ment.

A few days after the appoint­ment, the nur­se will con­tact you to ensu­re that the treat­ments are as plan­ned at home. During the period, you will be in con­tact with the nur­se accor­ding to an agreed sche­du­le. Also, dai­ly notes are made on mood, well-being and treat­ments. The mar­kings allow the Tuu­ma nur­se to moni­tor the progress of the treat­ment.

The treat­ment effect assess­ment is sup­por­ted by a BDI ques­tion­nai­re, which is con­duc­ted at the begin­ning and end of the period. At the end of the period, the treat­ment device will be retur­ned to Tuu­ma. If the patient has bene­fi­ted from the treat­ment, the effect may be enhanced or main­tai­ned by fol­low-up treat­ment, the length and frequency of which will be asses­sed on a case-by-case basis.

Tuu­ma also pro­vi­des the­ra­peu­tic sup­port exerci­ses that can be done during sti­mu­la­tion. The pur­po­se of the exerci­ses is to acti­va­te the sti­mu­la­ted neu­ral network and enhance the effect of the treat­ment. The exerci­ses are based on cog­ni­ti­ve beha­vio­ral the­ra­py (CBT). Exerci­ses aim to (1) iden­ti­fy causes and solu­tions to cur­rent problems, and (2) learn new ways of resol­ving proble­ma­tic situa­tions that impro­ve the qua­li­ty of life.

The Soo­ma tDCS device used in the treat­ment of the Tuu­ma Cli­nic is manu­fac­tu­red by Soo­ma Oy of Fin­land. The device is CE mar­ked and inten­ded for medical use. Accep­table indica­tions for the device inclu­de, in addi­tion to depres­sion, chro­nic neu­ro­pat­hic pain and fibro­my­al­gia.

Follow-up treatment

Furt­her treat­ment can be plan­ned if the first cour­se of treat­ment has a posi­ti­ve effect on well-being. In some cases, a lon­ger than usual treat­ment period may be use­ful to enhance the effect of the treat­ment.

Each 10-week fol­low-up period at Tuu­ma inclu­des 30 ses­sions. During a fol­low-up period, treat­ments are less frequent than during the actual treat­ment period. Period length and frequency of treat­ments are plan­ned in Tuu­ma. The deci­sion is influenced by eg. treat­ment his­to­ry, treat­ment res­pon­se, and time elap­sed after the end of the treat­ment period. The cost of fol­low-up care is deter­mi­ned by the treat­ments, more details can be found in the price list.

Typical­ly, fol­low-up treat­ment is star­ted with three weekly treat­ments. The weekly num­ber of treat­ments may be chan­ged if, des­pi­te the treat­ments, the con­di­tion dec­rea­ses and the symp­toms of depres­sion begin to recur.

Up to two months after the end of the last treat­ment period may be used for furt­her treat­ment. It is advi­sable to start the fol­low-up treat­ment when the effect of the treat­ment is still noticeable.

If you need a new head cap or elect­ro­des for fol­low-up treat­ment, you can get them from Tuu­ma (50 € / pc).

If you would like to attend a treatment period at Tuuma Clinic
  1. Ask your doc­tor to eva­lua­te the sui­ta­bi­li­ty of the treat­ment for your situa­tion.
    For example, he can use the tDCS info below to sup­port deci­sion making.
  2. Ask your doc­tor to wri­te a refer­ral to Tuu­ma Cli­nic
  3. Ask the doc­tor to inform Tuu­ma Cli­nic about the refer­ral with an email to tuuma@soomamedical.com
  4. To book an appoint­ment, visit tuumamedical.com/booking
  5. Bring the refer­ral with you to Tuu­ma Cli­nic

A psyc­hiat­ric specia­list may refer you to a depres­sion treat­ment to the Tuu­ma Cli­nic. If your doc­tor is not yet awa­re of tDCS treat­ment, you can sug­gest it your­self. From the link below find a down­loa­dable info docu­ment of tDCS treat­ment, which can be used to sup­port deci­sion making.

Contraindications to tDCS treatment

  • Int­rac­ra­nial metal­lic implant or other inter­nal metal part in the head (shunt, clip, sti­mu­la­tor)
  • Pace­ma­ker
  • Acu­te rash or ulce­ra­tion in the sti­mu­la­tion area
  • Serious men­tal disor­der (eg schizoph­re­nia, other psyc­ho­ses or seve­re per­so­na­li­ty disor­der)

Pos­sible cont­rain­dica­tions to tDCS treat­ment are asked befo­re star­ting the treat­ment period. Amal­gam fil­lings, braces and den­tal implants are not cont­rain­dica­tions to treat­ment.

Refe­rences

  1. Bog­gio P.S., Rigo­nat­ti S.P., Ribei­ro R.B., Mycz­kows­ki M.L., Nitsche M.A., Pascual-Leo­ne A., Freg­ni F. 2008. A ran­do­mized, double-blind cli­nical tria­lon the efficacy of cor­tical direct cur­rent sti­mu­la­tion for the treat­ment of major depres­sion. Int J Neu­rop­syc­hop­har­macol, 11(2), 249–54. Avai­lable onli­ne: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372849/
  2. Apa­ricio LVM, Rosa V, Razza LM, Sam­paio-Junior P, Bor­rio­ne L, Valien­go L, Lotu­fo PA, Ben­señor IM, Fra­guas R, Mof­fa AH, Gat­taz VF, Bru­no­ni AR. 2019. Transc­ra­nial direct cur­rent sti­mu­la­tion (tDCS) for pre­ven­ting major depres­si­ve disor­der: Results of a 6‑month fol­low-up. Avai­lable onli­ne: https://doi.org/10.1002/da.22878
  3. Bru­no­ni et al., Transc­ra­nial direct cur­rent sti­mu­la­tion for acu­te major depres­si­ve epi­so­des: meta-ana­ly­sis of indi­vi­dual patient data. The Bri­tish jour­nal of Psyc­hiat­ry (2016) 208, 1–10.
  4. Bik­son M. et al., Safe­ty of Transc­ra­nial Direct Cur­rent Sti­mu­la­tion: Evi­dence Based Upda­te 2016. Brain Sti­mul. 2016 Sep-Oct; 9(5): 641–61.
  5. Soo­ma — Treat­ment Outco­mes (2018). Avai­lable onli­ne: https://soomamedical.com/blog/treatment-outcomes‑2/

This ser­vice is not inten­ded for use in medical emer­gencies. If you sus­pect you are in a medical or psyc­ho­lo­gical emer­gency, imme­dia­te­ly call the emer­gency num­ber in the count­ry whe­re you are, or go to the nea­rest emer­gency room. In Fin­land the emer­gency num­ber is 112.

MIELI The Natio­nal Men­tal Health Associa­tion of Fin­land’s Men­tal Health Ser­vice pro­vi­des discus­sion assis­tance. In addi­tion to Fin­nish, the emer­gency pho­ne is avai­lable in Swe­dish, Ara­bic and English. The num­ber is 09 2525 0111 and is open eve­ry day and night of the year.