What About The Fisher-Wallace Stimulator For Anxiety And Depression?

Because I blog about medical topics, I see a lot of ads for medical devices. Lately, I’ve been seeing a lot of ads for a device called the Fisher-Wallace Stimulator. The device uses transcutaneous electrical stimulation of the brain and their website and ads say it is effective for the treatment of anxiety and depression.

The author I quote in this text immediately below concludes that the Fisher-Wallace Stimulator is no reliable research to support its use and that their marketing material contains a number of serious inaccuracies.

That said, transcranial direct current stimulation* for the treatment of depression and other psychiatric disorders is a legitimate topic that has potential. Please see the three articles listed below in Additional Resources.

One of the coauthors of Resource (1) wrote the following on forums.studentdoctor.net in response to the question “Why isn’t Fisher Wallace Cranial Simulator and similar devices prescribed/discussed more?”:

Before I go much further, I want to preface this by saying that the Fisher-Wallace Stimulator uses tACS (transcranial alternating current stimulation), also known as CES (cranial electrical stimulation). This is distinct from tDCS (transcranial direct current stimulation). Fisher-Wallace would like you to believe that they’re basically the same thing, since tDCS is much more well-established in the literature on the topic, but they’re different.

I co-wrote a review article on tDCS for the Am J Psych residents’ journal which just came out a couple of days ago:
http://ajp.psychiatryonline.org/pb/…esidents-journal/2015/October_2015.pdf#page=2 In retrospect, maybe I should have said more about tACS/CES in that article, but I didn’t think to mention it because I was trying to focus on stuff that is actually shown to work.

We’re very careful on this forum to avoid giving medical advice to patients, since we can’t give you accurate advice without personally examining you. I’ll give some general answers here because neuromodulation is a strong interest of mine.

The reason why it’s not commonly prescribed is because it’s not FDA approved for anything. The Fisher Wallace people try to trick you by saying it’s “FDA cleared,” but what that actually means is that the FDA said that they do not need to “approve” or “reject” it because they don’t consider it to be a medical device.

The questioner cites a public relations release from Fisher-Wallace that makes a number of claims.

The author states, of the the press release:

That press release you cited was written by Fisher Wallace. It has several misleading things in it. They quoted those “top psychiatrists,” but when I tried to search for the source of those quotes, I didn’t find any such references aside from “quotes” listed on Fisher Wallace’s own website. Also, one of those two “psychiatrists” (Richard Brown) isn’t actually a psychiatrist, he’s a psychologist who is known for touting questionable alternative treatments. The other one (San Martin) doesn’t do any research on electrical stimulation of the brain, and doesn’t say anything about it in any of the information on his own website or his own publications.

The world’s leading expert on transcranial electrical/magnetic stimulation is probably Sarah Lisanby, who is the chair of psychiatry at Duke and previously founded the brain stimulation division at Columbia (I’m mentioning this because the press release specifically cited Columbia). Here’s what she said in a recent article about the topic:
“Little consistency exists in the literature surrounding the specific parameters and electrode placements used, and there are no controlled trials on its use, making it difficult to draw conclusions about its potential value. In their meta-analysis, Klawansky et al (1995) concluded insufficient controlled evidence existed and that available evidence was probably not adequately blinded.”
And here’s the source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238088/ [Resource (2) below]

Resources:

(1) Transcranial Direct Current Stimulation: Theory, Treatment of Major Depressive Disorder, and Other Neuropsychiatric Applications  [Full Text PDF] October 2015. Shan H. Siddiqi, M.D., Nicholas T. Trapp, M.D. The American Journal of Psychiatry Residents’ Journal

(2) Somatic Treatments for Mood Disorders [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Neuropsychopharmacology. 2012 Jan; 37(1): 102–116. Moacyr A Rosa and Sarah H Lisanby

(3) Therapeutic Efficacy of Neurostimulation for Depression: Techniques, Current Modalities, and Future Challenges [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Neurosci Bull. 2016 Feb;32(1):115-26. doi: 10.1007/s12264-015-0009-2. Epub 2016 Jan 19.

 

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