As a follow up to the video about EEG-assisted hypnosis, I came upon an article today about how EEGs could be implemented in talk therapy and traditional Psychiatry.
In many ways, modern day mental health is still a series of trials and errors. If you are depressed your psychiatrist may start you out on a regimen of Wellbutrin. After the medicine has been given adequate time to take effect, the therapist will determine if the treatment is working by asking you questions about your subjective experience. If it turns out the drug isn’t working, the dosage may be increased, a new drug may be prescribed or a new approach may be recommended. This can be frustrating for both clients and therapists.
There are a lot of external variables that can make your subjective experience of a therapy’s effectiveness differ starkly from reality. Further compounding the problem is how long it can take for a drug to have a meaningful impact on people, to the extent that one could reliably say “this is working for me.” Under normal circumstances, six to eight weeks will pass before any real benefits will be noticed. Many people are also resistant to specific psychoactive drugs, and some people seem to have very little reaction at all to any drug.
To help solve this problem, a new EEG device is being developed specifically with psychiatrists in mind. It monitors brainwaves and uses the analysis to determine if a certain drug is having the expected effect. If the drug is doing its job, or is likely to work in the future, brain activity in specific areas will change. Studies of this have shown that it can take as little as a single week to reliably determine if a particular therapy is working – long before any subjective effects would normally be noticed by the patient or therapist.
The new device is also meant to be simple to use, so it can be easily employed with minimal training, and could even be operated by office staff such as a nurse:
Requiring only five electrodes to be placed on a subject’s forehead and temples, rather than 20 or more electrodes scattered over the entire scalp, the device is much easier to use than the EEG systems typically employed in research labs.
The company is now sponsoring a large, multicenter clinical trial to determine if the device can reliably detect antidepressant response. Initial results from the study, presented this week in San Diego at a meeting of the American Psychiatric Association, are promising. After a week of treatment, the device could predict if a particular drug would work in the longer term 70 to 80 percent of the time.
“Psychiatry is the last specialty without a good diagnostic test to guide treatment,” says Andrew Leuchter, a researcher and psychiatrist at the University of California, Los Angeles, and a study leader. “I think there is a lot of enthusiasm for a quick test that can be carried out in the doctor’s office and inform treatment.” Leuchter’s group did some of the early research underlying the device, and he heads Aspect’s science advisory board.
Aspect expects to finish the trial of more than 300 patients this year and is in talks with the Food and Drug Administration (FDA) about requirements for regulatory approval. The company eventually aims to market the device to psychiatrists. “Many patients will abandon their medications if they do not feel sufficient improvement in the first few weeks,” says Maurizio Fava, a psychiatrist at Harvard Medical School and Massachusetts General Hospital, in Boston. “So having a reliable prediction will help patients stay on track.”
Another device mentioned in the article, called the NeuroStar, is designed to be used with patients that seem resistant to all drugs. It stimulates the brain with magnetic pulses through the skull, and in trials it worked 40 percent of the time. The NeuroStar is meant as an alternative to the very invasive “electroconvulsive therapy”, which requires surgery and has some nasty side effects, but is needed in severe cases where the patient is resistent to drugs.
Though it is not mentioned in the article, audio/visual Brainwave Entrainment could also be a very effective, easy to use and certainly noninvasive way to assist the modern therapist in treating a wide variety of clients. We have many users of our products who experience great relief with BWE where they found none with other therapies. We get a lot of calls from new therapists interested in this technology, most of which heard about it through their clients! Many of them are now sending their patients home with BWE CDs created using our software. Some are even setting up “brainwave entrainment” rooms, complete with a lazy boy, a Light/Sound Synergizer and a laptop to drive the stimulation.
Emerging neurotechnology is going to vastly change the mental health industry in the coming decades .
On the other hand ….
Perhaps someday, a visit to the psychiatrist’s office will resemble a trip to the dentist’s or physical therapist’s office, where a mental hygienist, rather than a dental hygienist, will work on your brain before the doctor comes in to render his final opinion.
I think one of the better aspects of traditional psychiatry is the stereotypical therapist’s office: the couch, the plants, the dim lighting, the shelf full of books probably never read… Many people loathe visiting the dentist or doctor. The lighting is too bright, the mood feels rushed, like an assembly line. I rarely spend more than 3 or 4 minutes with my doctor – most of every visit is spent in the waiting room or talking to the nurse. I think it is important not to let the mental health industry fall into that trap. A therapist’s office should be a comfortable place. Don’t abandon the couch. Instead, employ these new technologies to ensure clients are receiving the best treatment available.
Here’s the article: http://www.technologyreview.com/Biotech/18791/