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I have a weird cancellation break in clinic, so I am going to try the Fisher-Wallace device for the first time right now. It's a cranioelectrostimulation device similar to (yet different from) alpha-stim.
The Fisher Wallace is FDA cleared for depression, insomnia, and anxiety, is available by prescription in US. It has about 20 studies (compared to the alpha stim's several hundred).
The possible advantages of the Fisher Wallace are cost (it is $200 cheaper than alpha stim) and electrode placement (temples instead of earlobes, so theoretically it may not cause the same dizziness and vestibular issues as some folks get with the alpha stim).
I bought the device at the normal discount they give for licensed prescribers in the US. ($299, email them to figure out the details, you must send a photocopy of your active license to get it). Otherwise folks need a prescription.
For most folks it is $599, for active military $499 I think..
We've had a lot of success with the alpha stim, especially for people with anxiety. It doesn't work for everyone, but if someone uses it regularly, it can be very effective. I've been using mine for 1.5 years now and still feel positive effects from it.
Here's my blog post about it (from when we first started using it): psychologytoday.com/us/blog/evolut…
About 10 min into my first Fisher Wallace treatment. I felt a little "off" at first similar to alpha stim. That faded to a better, neutral sensation rapidly, within a minute or two. I'm marginally more relaxed.
Not dizzy at all, but I'm using the lowest stim setting (as recommended by the video on their website, though the written information that came with the device says start at level two).
Device is pre-programmed for 20 min (alpha stim lets you choose 20, 40, or 60 min). Should be over soon. I feel okay, a little more alert than when I started. Not quite as relaxed as alpha stim, but not a fair comparison given I'm using FW for a short time at the lowest stim.
Done, I have a little headache from the headband you have to wear (you wear an elastic headband over sponge electrodes that you stick in water and place on the temples, sponges have to be replaced weekly, but aren't terribly expensive).
I don't feel dizzy or seasick at all, which is a good sign. Alpha-stim sometimes leaves mild residual dizziness that goes away, but is unpleasant.
The reason we got alpha stim first in the clinic was from a report of a fellow psychiatrist who tried several different models (including FW) and likes AS best...also there's a goofy comparison trial at the VA of several models. Vets tried all of them then could pick one,
...and most went for the alpha stim. However, the vestibular issue is real, probably makes AS unusable for 10% of people maybe? BUT the headband and sponges make FW a lot harder for people to try for free in clinic (the tiny electrode pads we change out on the AS are cheap)
HOWEVER, both require 3 weeks, really, of nearly daily use to see if it really works. FW has a very good return policy. AS is great about replacing broken machines but does not have a "it doesn't work" return policy.
Not sure exactly how Fisher Wallace will fit into the clinic except for those who are really stuck with anxiety or insomnia but can't tolerate alpha stim and are willing or want to try another stimulator. I can get them for approximately the same price for patients.
OH CRAP => Previously unreported side effect. Just spilled the cup of water used to wet the sponges all over my chair, and now it looks like I wet my pants.
(I do not have anxiety but it did help me get better, more restorative sleep, quantitatively and qualitatively, and it chills me out before a public speaking engagement or dealing with the irritations of the airport)
It's Monday and I'm jet-lagged 😡
Deleted my last tweet because it's not an RCT, I got that impression from the report on it, but I was incorrect. Brand new alpha stim study of 115 patients in national health service. alpha-stim.com/clinical-effec…
Anyway, lots of folks are wary of stim because it seems like 🐄💩 (I certainly thought so for a long time, before I looked into it), or it seems new and scary. Fisher Wallace was FDA cleared 20 years ago. Alpha stim was invented in 1978 and cleared in 1992.
The devices and technologies were quite expensive until recently. Alpha stim has been studied in some very ill populations...head injuries, tons of meds, inpatient psych units, seizures...which I find reassuring as well.
(FDA "clearance" just means the device is cleared for medical use in humans. There's a lower standard for clearance than "FDA approved" for meds, if you are wondering why I am using that word.)
Follow up on Fisher Wallace....a few hours after I got a headache which is unusual for me, however I had one yesterday too (started during hour 4 of a 12 hour airport journey...).
