Combination therapy for the treatment of depression
Provided are methods for treating depression and depression-related conditions by combining administration of pharmacologic agents and neuromodulation induced by transcranial electrical stimulation.
1 . A method of treating depression in a patient in need thereof comprising administering to the patient:
(a) a selective serotonin reuptake inhibitor (SSRI); and
(b) trans-cranial electrical stimulation by applying current in a direction of flow from a first electrode disposed over a region of a left prefrontal cortex of the patient to a second electrode disposed over a region of a right prefrontal cortex of the patient, the first electrode and the second electrode each having a conductive surface area greater than 20 cm 2 and less than 25 cm 2 ;
wherein a lower dosage of the SSRI is administered to the patient as compared to an individual receiving the SSRI alone.
2 . The method of claim 1 , wherein the lower dosage comprises one or more of a lower quantity of the SSRI, a frequency of administration of the SSRI, and a duration over which the SSRI is administered.
3 . The method of claim 1 , wherein the SSRI comprises fluoxetine.
4 . The method of claim 3 , wherein the lower dosage of the fluoxetine comprises 42.5 mg or less.
5 . The method of claim 3 , wherein the lower dosage of the fluoxetine is at most 5 mg less than the dosage of the fluoxetine alone.
6 . The method of claim 3 , wherein the lower dosage of the fluoxetine is at most 11% less than the dosage, by milligrams, of the fluoxetine alone.
7 . The method of claim 3 , wherein the lower dosage of the fluoxetine is 50-99% of the dosage, by milligrams, of the fluoxetine alone.
8 . The method of claim 1 , wherein the SSRI comprises citalopram.
9 . The method of claim 8 , wherein the lower dosage of the citalopram comprises 18.9 mg or less.
10 . The method of claim 8 , wherein the lower dosage of citalopram is at most 2.2 mg less than the dosage of the citalopram alone.
11 . The method of claim 8 , wherein the lower dosage of citalopram is at most 11% less than the dosage, by milligrams, of the citalopram alone.
12 . The method of claim 8 , wherein the lower dosage of the citalopram is 1-49% of the dosage, by milligrams, of the citalopram alone.
13 . The method of claim 8 , wherein the lower dosage of citalopram is cessation of citalopram.
14 . The method of claim 1 , wherein the SSRI comprises sertraline.
15 . The method of claim 14 , wherein the lower dosage of the sertraline comprises 81.4 mg or less.
16 . The method of claim 14 , wherein the lower dosage of sertraline is at most 23.7 mg less than the dosage of the sertraline alone.
17 . The method of claim 14 , wherein the lower dosage of sertraline is at most 23% less than the dosage, by milligrams, of the sertraline alone.
18 . The method of claim 14 , wherein the lower dosage of the sertraline is 1-49% of the dosage, by milligrams, of the sertraline alone.
19 . The method of claim 14 , wherein the lower dosage of the sertraline is 50-99% of the dosage, by milligrams, of the sertraline alone.
20 . The method of claim 14 , wherein the lower dosage of sertraline is cessation of sertraline.
21 . The method of claim 1 , wherein the region of the left prefrontal cortex is a left dorsolateral prefrontal cortex of the patient and the region of the right prefrontal cortex is a right dorsolateral prefrontal cortex of the patient.
22 . The method of claim 1 , wherein the current has an amplitude in a range between about 0.5 milliamps (mA) and about 4 mA.
23 . The method of claim 1 , wherein the applying the current includes ramping up the current from 0 mA to a maximum amplitude over a first period of time, delivering the current at the maximum amplitude for a second period of time, and ramping down the current from the maximum amplitude to 0 mA over a third period of time.
24 . The method of claim 1 , wherein the administering the trans-cranial electrical stimulation includes administering the trans-cranial electrical stimulation over a plurality of treatment sessions, each treatment session of the plurality of treatment sessions including the applying of the current in the direction of flow for a predetermined amount of time.
25 . The method of claim 24 , wherein the administering the trans-cranial electrical stimulation over the plurality of treatment sessions includes administering at least three treatment sessions of the plurality of treatment sessions per week.
26 . The method of claim 24 , wherein the predetermined amount of time is between 1 minute and 50 minutes.
27 . The method of claim 1 , wherein a current density of the current being applied across a surface of the first electrode is greater than about 0.08 mA/cm 2 and less than about 0.1 mA/cm 2 .