The FDA just approved an at-home device for difficult to treat depression, and today we talk with the lead investigator on the trial, Linda Carpenter.

Welcome to the Carlite Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlet Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

On January 12, 2006, the FDA approved the first at-home device for difficult to treat depression. ProLivRX

The decision came just a month after another historic approval. The flow device for general

depression. Whether you are a psychiatrist, a PA or a psych NP, these therapies are going to

change how we practice, bringing a third

path, neuromodulation, into the office, alongside the well-trod paths of psychotherapy and

psychopharmacology. But unless you've been working in a TMS clinic, this is probably an unfamiliar

path. So, let's start with some basics.

Neuromodulation is when you change or modulate neuronal activity.

We do this already with medications, which is sometimes called chemical neuromodulation,

but usually we say it to mean electrical neuromodulation,

which includes ECT, TMS, even the TENS unit for pain.

Those are all non-invasive, meaning there is no surgery or implant a device.

But we also have invasive neuromodulation in psychiatry for depression,

deep brain stimulation and vagal nerve stimulation.

These new approvals, flow and prolive RX are both electrical neuromodulators.

Like TMS, transcranial magnetic stimulation, they are non-invasive, but unlike TMS, they can both be done in the home, without a technician present.

Both are bands that the patient wears around their head, but this is where their similarities end.

They operate through different mechanisms in different parts of the brain.

...