There are many effective treatments for depression. One major issue is identifying which treatment will work most effectively for a patient. Discussing different options, together with their risks and benefits, will help to identify the most effective treatment, and engage the patient throughout the treatment.
Outlined below is more information to help guide your patient when you are discussing using the Flow depression treatment.
Is Flow suitable for all patients?
Will be updated shortly
How do I get my patient started on Flow?
When you and your patient have decided that Flow is the right treatment at this stage of the depression, the following steps will help to get them started.
1. Order the Flow device
Your patient can order the device by visiting flowneuroscience.com. They will be asked questions about their condition e.g., if they have a metal plate in their head, previous cases of epilepsy and other criteria where using the device is not recommended. The are strongly advised to have a contact with a healthcare professional in addition to using the Flow – Depression. After they have answered the questions, the device can be shipped to the UK and Sweden within a couple of days.
2. Download the app
Your patient can then download the Flow virtual therapy app and start the program. The app is free of charge and can be used without the device. After downloading the app, your patient will be asked to create a new account with the help of their email address.
3. Start treatment
After having signed up in the app, your patient can start the guided therapy program without any extra help from a healthcare professional. Both the app and device are designed to be used by the patient at home in a safe way. After 6 weeks of the intense program, the patient can continue using the headset for 2 days per week as a maintenance treatment.
Aspects to consider before recommending Flow
Using treatment with Flow
The Flow device should not be used as a mono-therapy for patients with a severe depression and/or suicidal ideation. If your patient suffers from severe depression, consider using Flow as an add-on treatment to the already existing stable treatment program. Regular follow-ups, as with every treatment in this condition, is required.
Patients who have experienced previous hypomanic or manic episodes
Treatment emergent mania has not been shown to increase if using tDCS to treat unipolar depression. In a meta-analysis by Brunoni et al., 2017, TEM during tDCS was reported in 13 cases. The meta-analysis compared the rate of TEM in active and sham groups of the RCTs. 8 of 226 (3.5%) and 1 of 190 (0.5%) participants presented TEM. This difference was not statistically significant (OR = 1.79, 95% CI = 0.6 to 5.32).
Patients who have experienced previous Treatment Emergent Mania (TEM) are nevertheless recommended to use the Flow depression treatment under an ongoing supervision of a doctor, psychologist or other healthcare professional.
Patients who have a hard time understanding and following instructions
Patients with cognitive disabilities, or those who have problems reading or understanding written instructions, should be informed and assisted.
Patients who are older and may have a problem with fine motor control
Before recommending the Flow device to an older patient who may have issues with fine motor control, it should be explained to them that they should be familiar with using smartphone apps before ordering the device.
Patients with brain damage or those who have head implants
We do not recommend using the Flow device if the patient has had any type of implant in the skull, or if they have had brain damage e.g., a stroke.