Psychiatrists use their best judgment to determine which psychiatric medications can help their patients – for ADHD, depression, anxiety and panic attacks, mood issues, bipolar disorder, etc.
But figuring out the right medication or combination of meds can take significant time and effort. For some patients, the medications never seem quite right.
Predicting Medications – One Person at a Time
A new test called rEEG analyzes brain patterns using an EEG. It then identifies which medications the psychiatrist should try first based on the patient’s specific brain patterns. A report is generated for the psychiatrist that shows a ranking of which medications and which combination of medications make sense to try.
The test can often reduce trial and error with medications by basing decisions on specific physiological brain measures. It’s one of the few tests available to psychiatrists that actually measures brain activity and can help determine appropriate medication selection.
Who Needs the Test Most?
The most logical use is for:
- Patients who are about to start on psychiatric medications or have just started.
- Someone on medication who still struggles with symptoms or side effects.
- Someone on several psychiatric medications who wants to see if less could be used.
If you’re on psychiatric meds and symptoms are very well-controlled, you’re unlikely to want to invest in this test.
What Happens During the Test?
For the rEEG test, the client sits in a comfortable chair while 21 electrodes are attached to the scalp using a small amount of conductive paste. While the client relaxes, the brain patterns are recorded for 15 minutes. After the 15-minute recording time, the electrodes are removed, and the test is sent to a company that analyzes the EEG and creates the report for the psychiatrist. The entire test takes approximately an hour.
How We Chose to Offer This Test – Impressive Reports from Psychiatrists
Over the years, we met psychiatrists at various conferences, including the American Psychiatric Association conference, who use the rEEG test. We were impressed by their experience and their enthusiasm for the test. It’s a great innovation — an evidence-based approach that was better than trial-and-error meds.
These psychiatrists said it was a very valuable tool in speeding up the process. It helped them choose the right medication for their patients – and also helped reduce symptoms faster. They said sometimes the test predicts combinations of medications they’d probably never have tried otherwise. In addition, it often helps rule out the use of certain medications. For example, it might say NOT to use a stimulant or antidepressant and instead suggest a different class of meds – whereas without looking at brain patterns, most psychiatrists would typically try a more standard approach.
The test was developed by a group of psychiatrists in California over a 15-year period. They analyzed thousands of patients’ individual patterns. They developed algorithms to predict which brain patterns are likely to respond best to a medication or some combination of medications.
How Is the Test Ordered?
The Center for Brain Training does the recording of the EEG. Our Center or the psychiatrist helps provide you with certain rules to follow to prepare for the test. After recording the EEG, it is sent to be analyzed. A report is then sent to the psychiatrist.
The test must be prescribed by a psychiatrist who is familiar with how to read the report – or who’s willing to learn how to use it. If your current psychiatrist is not interested in committing the time to learn the rEEG test, Dr. Quinones, an experienced psychiatrist who works with our office can help administer and interpret the rEEG report.
At this point, the rEEG medication prediction report costs around $400. There’s a cost of $225 to record the EEG and send it for analysis. These are out-of-pocket costs. This new report is not yet approved by most insurance companies, and it can take some time for newer tests to get approval. There are relevant insurance codes that can be submitted to your insurance company in case coverage changes.
Any visits to the psychiatrist to discuss the report or get treatment recommendations would be charged separately and would be considered normal medical costs likely covered by insurance. Contact us to learn more.
How Does the Psychiatrist Use the Report?
The report gives the psychiatrist rankings of a variety of medications and classes of medications. While they are identified as to which are likely to produce the best results, there can be several options. The doctor still has to figure out which of the ranked options to try first. He or she will do that based on symptoms, any previous response to medications, as well as knowledge regarding previous report experience indicating how and when to try each option.
The skill and experience of the psychiatrist is still an important factor. The test allows a more targeted testing based on the client’s brain patterns. This should typically speed up the process of finding the right meds. It also helps identify combinations that may not be otherwise identified.
What Ages of People Can Use This Test?
Children from age 6, to adults age 90+
Impressive New Research
There are at least 11 published studies on rEEG. A very good study on treatment-resistant depression was just released. Treatment-resistant depression can be a difficult issue for psychiatrists and challenging to medicate successfully. Breakthroughs in treatment for this are very rare.
A new published study using the rEEG test showed significant improvements in outcomes for patients categorized with treatment-resistant depression. The paper was published in the July 2010 Journal of Psychiatric Research and included work from Martin Teicher, a noted psychiatrist at Harvard, as well as researchers from Stanford and Cornell Universities.
With over 11 studies covering a number of psychiatric issues, here are a few of the published findings:
- Positive treatment responses (CGI-Improvement scores of 2 or 1) in 82% of patients.
- Robust and highly-consistent with effectiveness rates exceeding 69% across numerous psychiatrists practicing in diverse settings.
- Nonintuitive medication and medication combinations were often discovered.
- Enhanced treatment compliance and decreased dropout rates were noted.
