Treat depression differently
- tDCS headset to treat mild, moderate and severe depression
- Used by the NHS and 150+ private clinics
Treat depression differently
- tDCS headset to treat mild, moderate and severe depression
- Used by the NHS and 150+ private clinics
Used by the NHS
Trusted by 20,000 users
Used in over 150 Clinics
Increase patient choice
A new treatment option
Give your patients another effective way to treat their depression. Use as a standalone treatment or combine with existing protocols.
Enhance results
Flow was twice as effective as 21 best selling antidepressants, in a placebo controlled, double-blind, randomised controlled trial.
Deliver remote care
Monitor and optimise treatment plan with our digital platform. Only available for clinicians.
How does it work?
There is an association between lowered activity in the dorsolateral prefrontal cortex and depression.
Flow works by using tDCS (transcranial Direct Current Stimulation) to stimulate the brain and help restore activity, relieving depressive symptoms.
The headset is typically used 3-5 times a week by the patient at home, each session is 30 minutes.
Clinicians oversee adherence and amend the treatment protocol via a digital platform.
Over half of patients in remission
A large, randomised placebo-controlled tDCS trial showed that the Flow tDCS device was superior to sham stimulation for the treatment of Major Depressive Disorder (MDD).
Results based on MADRS show a 57.5% remission rate (vs 29.8% placebo) and 62.7% response rate (vs 32.2% placebo) at week 10.
Full clinical trial results will be peer reviewed and published in 2024.
Double-blinded, placebo-controlled clinical trial (n=173) to measure the effectiveness and safety of Flow’s at-home tDCS depression treatment (2023).
NICE reviews our clinical trial
NICE has reviewed Flow’s evidence for the treatment of depression, and have interviewed a number of experts about the value of Flow to patients and the NHS.
They conclude that "There is high-quality, comparative evidence from the UK that Flow can improve symptoms of depression and lead to remission".
"None of the clinical experts were aware of any issues that could prevent this technology or procedure being adopted in the NHS".
No major side effects reported
Flow’s real-world data shows less than 2% report minor side effects such as headaches and skin irritation.
A 2020 study found effects to be mild, transient and well-tolerated.
For the majority taking antidepressants, side effects are inevitable; a large international cohort showed that 61% of users reported at least 10 adverse effects, such as feeling emotionally numb (71%) and suicidality (50%).
How businesses work with Flow
The NHS has 4 pilots live across Primary and Secondary Care
We are currently working with the NHS to pilot Flow in Primary Care via GPs, Community Mental Health and Postnatal Services.
Sensus Clinic uses Flow to increase patient choice
Psychiatrists at Sensus use Flow to enhance existing treatments such as antidepressants, and with treatment-resistant patients.
Well Pharmacy promotes and distributes Flow
Well Pharmacy, the third largest pharmacy in the UK, promotes Flow in store and sells headsets through their website.
Leading academics support Flow
Flow’s exciting and encouraging data raise the prospect of a real advance in the treatment of depression…a helpful intervention for many people suffering from major depression.
Allan Young
Chair of Mood Disorders, King’s College London
Flow’s results show a clear separation of active and sham treatment in a large, multisite randomised controlled trial… a very promising development in mental health treatment.
Corey Keller
Assistant Professor of Psychiatry and Behavioural Sciences, Stanford University
Flow has gained popularity among our patients. This positive reception speaks volumes about the effectiveness and patient satisfaction associated with Flow.
Dr Azhar Zafar
GPA Director of Research, NHS GP
Patients rate us 'Excellent' on Trustpilot
Over 30 RCTs show tDCS is safe and effective
Approved for at-home use across the UK and EU
FDA breakthrough device designation for at-home depression treatment
Approved by the British Standards Institution (BSI)
Class IIa medical device CE-marked. Approved for use in the EU and UK
Tested according to IEC 60601 for electrical medical device safety
Flow in the media
FAQs
Over 12,000 people have used the Flow tDCS device. Less than 2% have reported side effects.
This list includes known side effects from the Flow tDCS device (until August 2023):
- Headache (~1.5 %)
- Skin irritation (~1.2%)
- Tinnitus (~0.6%)
- Mild skin burn (~0.5%)
- Worsening of symptoms (~0.4%)
- Increased anxiety (~0.3%)
- Skin redness (~0.15%)
- Stinging (~0.07%)
tDCS should NOT be used in the following cases:
- The patient has a cranial or intracranial implant
- The patient’s skull is not intact
- The patient has a skin condition, for example psoriasis
The following conditions are not contraindications, but may require extra precautions – such as careful monitoring:
- Bipolar disorder (or a history of hypomanic/manic episodes)
- Epilepsy (or a history of seizures)
- Heart disease
- Neurological conditions
- A recent surgical procedure
- An active implanted medical, metallic or electronic device (such as a cardiac pacemaker, spinal cord stimulator, cochlear implant, implanted hearing aid or defibrillator)
There is no evidence to suggest that tDCS treatment could be harmful to use during pregnancy. The electric current targets the brain directly without affecting the hormonal or digestive systems, making tDCS a tempting option for treating depression during the peripartum period.
However, more large-scale controlled trials are needed before any definitive conclusions can be drawn.
Today, the option to use tDCS during the peripartum period should be carefully evaluated in each individual case.
Encouraging research results for tDCS during pregnancy:
2018 – Kurzeck et al: A systematic review concluding that the scientific evidence for tDCS during pregnancy is sparse but promising.
2019 – Vigod et al: A pilot randomised controlled trial showing promising results for tDCS during pregnancy. There were no serious adverse events.
2022 – Laurin et al: A systematic review including seven studies and 33 women. No serious adverse effects for the mothers or children.
Weeks 1-3: Includes 5 stimulation sessions a week, each 30 minutes long.
Weeks 4 and beyond: Includes 1-2 stimulation sessions a week, each 30 minutes long.
Patients usually see results within the first 3 weeks of treatment. The length of the treatment depends on depression severity and chronicity in each individual case. A recent RCT study showed that 57% of participants with moderate to severe depression reached remission within 10 weeks.
Clinicians can create custom schedules.
There is currently Level B evidence (probable effect) for the use of tDCS on several conditions. A few of these conditions are treated by targeting the same area as the Flow tDCS device – the left dorsolateral prefrontal cortex (DLPFC).
tDCS treatment usually targets the left DLPFC in:
- Cognitive symptoms of Parkinson’s disease
- Auditory hallucinations in Schizophrenia (however the cathode is placed differently – over the left temporoparietal area)
A minority of studies have used the left DLPFC as a target for the treatment of pain disorders.
tDCS treatment usually targets other brain areas in:
- Alcohol addiction (usually the right DLPFC)
- Epilepsy (cathode placed over the affected area)
- Neuropathic pain (motor cortex)
- Migraine (motor cortex)
- Fibromyalgia (motor cortex)
- Stroke rehabilitation (motor cortex)
Level C evidence
There is currently Level C evidence (possible effect) for the use of tDCS in:
- Obsessive-Compulsive Disorder (targeting the pre−SMA)
- Aphasia (various placements, some targeting Broca’s area)
ADHD
There is promising and growing evidence for tDCS treatment of ADHD symptoms.
In 2022, a randomised, double-blind, controlled trial showed that at-home tDCS treatment significantly improved attention in 64 adult patients with ADHD. The treatment used the anode over the right DLPFC.
Clinical trials indicate that tDCS sessions can be used for at least 6 months without any changes in side effects, suggesting the treatment is suitable for long-term use.
There is no evidence to suggest that side effects would increase beyond 6 months, but few such long-term studies exist.
In comparison, most clinical studies on antidepressant medication follow up for a maximum of 5 months.
There is promising evidence indicating that tDCS can be used to prevent relapse.
See for example:
2019 – Aparicio et al: After the initial protocol of 15 tDCS sessions, participants were offered 2 weekly tDCS sessions for 6 months. The treatment was well tolerated with relatively low levels of relapse.
2013 – Valiengo et al: tDCS was effective both as a treatment in the acute phase of depression and as relapse prevention.
Our trial will be peer reviewed and published in Q1 2024. In the meantime, you can hear Daniel our Chief Clinical Officer talking about the methodology and results in a webinar, here.