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Bipolar Disorder (BD)BDEPNCT07556692

A Study of Home-use Brain Stimulation to Treat Bipolar Depression

A study testing Flow FL-100 tDCS headset in people with Bipolar Disorder (BD), run by King's College London at 1 site in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Bipolar depression is a long-lasting and disabling condition, and many people continue to experience depressive symptoms despite standard treatments. Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation that uses a very small electrical current applied through the scalp and has… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bipolar Disorder (BD)
What is being tested?
Flow FL-100 tDCS headset
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
212 participants
Where
1 siteUnited Kingdom
Study dates
24 Apr 2026to 30 Nov 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults aged 18 years or over.
  • Diagnosis bipolar disorder in a current depressive episode based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria assessed by structured clinical assessment, Mini-International Neuropsychiatric Interview (MINI) (Sheehan et al.,1998).
  • Having at least a moderate severity of depressive symptoms as measured by a score of at least 18 in MADRS (Montgomery and Åsberg, 1979).
  • Either not taking antidepressant medication or taking a stable dose of antidepressant medication for at least 6 weeks before enrolment.
  • Either not currently in psychotherapy or in ongoing psychotherapy for at least 6 weeks before enrolment.
  • Being under care of GP.
  • Agreeable for GP to be regularly informed by research team about participation.
  • Able to provide written, informed consent.

Who cannot join

  • Significant suicide risk as measured by answering 'yes' to questions 4, 5 or 6 on the Columbia Suicide Severity Rating Scale (C-SSRS) Screen (Posner et al., 2011).
  • Primary comorbid psychiatric disorder (e.g. obsessive compulsive disorder) based on DSM criteria as assessed in MINI (Sheehan et al., 1998).
  • Having a Young Mania Rating Scale (Young et al., 1978) score of 20 or more.
  • Current daily use of medications that affect cortical excitability (e.g. benzodiazepines).
  • Current illicit drug use or heavy alcohol use with high risk of alcohol use disorder as measured by a score of > 8 in Alcohol use disorders identification test consumption (AUDITC) (Khadlesari et al., 2017; NICE, 2023).
  • History of electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), other brain stimulation, or psychosurgery for depression.
Show all 16Show fewer
  • History of esketamine / ketamine for treatment of depression.
  • Medical disorder that may mimic mood disorder (e.g. hormonal disorder).
  • History of myocardial infarction, coronary artery bypass graft (CABG), coronary heart failure (CHF), or history of other cardiac issues.
  • Have cognitive impairment (e.g. dementia).
  • History of a neurological disorder (e.g., cerebrovascular events, stroke, structural lesion, epilepsy, seizures, Parkinson's disease).
  • History of migraines or intractable headaches.
  • Implant in brain, neurocranial defect or active implantable medical device.
  • Shrapnel or any ferromagnetic material in head.
  • If female and of child-bearing potential, currently pregnant or planning to become pregnant during the study
  • Concurrent enrolment in another interventional study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Professor Cynthia Fu contact

0207848832

cynthia.fu@kcl.ac.uk

United Kingdom1 site, 1 recruiting
  • South London and Maudsley NHS Foundation Trust

    London

    Oluwatofunmi Olaniyan, +44 20 7848 8326, oluwatofunmi.olaniyan@kcl.ac.uk

    Recruiting

Other trials in United Kingdom

About this study

Official title: Home-based Transcranial Direct Current Stimulation in Bipolar Depression: a Randomised, Double-blind, Placebo-controlled Trial

Bipolar depression is a long-lasting and disabling condition, and many people continue to experience depressive symptoms despite standard treatments. Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation that uses a very small electrical current applied through the scalp and has shown promise as a treatment for depression. This study aims to find out whether a home-based tDCS device is effective and safe in reducing symptoms of bipolar depression when compared with a placebo (sham) treatment. The study will also look at how acceptable the treatment is to participants and how well people are able to use the device at home.

Who can participate? Adult patients aged 18 years and over who have a diagnosis of bipolar disorder and are currently experiencing a depressive episode.

Read more

What does the study involve? Participants must meet specific eligibility criteria, which will be assessed by the research team. People who do not meet the study criteria or for whom tDCS is not suitable will not be able to take part. Participants will be randomly assigned to receive either active tDCS or a placebo (sham) treatment. Neither the participant nor the researchers assessing outcomes will know which treatment has been assigned.

Participants will use a study device at home over a defined treatment period and will complete a series of assessments at set time points. These include clinician-rated interviews and self-reported questionnaires about mood and well-being. Device use and adherence data will be collected electronically. Participants will also be monitored for any side effects throughout their involvement in the study.

Although the study is multi-site, participation is primarily remote, with most study activities completed from the participant's home.

What are the possible benefits and risks of participating? Participants may experience an improvement in depressive symptoms. Information gained from this study may help improve future treatments for bipolar depression.

tDCS is generally well tolerated. Possible side effects include mild and temporary sensations such as tingling, itching, headache, or skin irritation at the electrode sites. All participants will be monitored for adverse events, and appropriate support will be available if needed.

Where is the study run from? The study is run from King's College London in collaboration with NHS research sites across the UK.

When is the study starting and how long is it expected to run for? April 2026 to October 2027

Who is funding the study? The National Institute for Health and Care Research (NIHR), UK.

Who is the main contact? Professor Cynthia Fu, the Chief Investigator at King's College London, cynthia.fu@kcl.ac.uk

Being tested
Flow FL-100 tDCS headset
Medical subject headings
Bipolar Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Flow FL-100 tDCS headsetDevice

    The Flow FL-100 tDCS device is an adjustable headset with the electrodes built in. It delivers low-intensity direct current through scalp electrodes, modulating cortical excitability in the dorsolateral prefrontal cortex (DLPFC). The device is portable and commercially available.

Study groups in NCT07556692
Study groupRoleWhat they receive
Sham tDCS + Treatment as UsualSham comparatorNot described
Receives: Device: Flow FL-100 tDCS headset
Active tDCS + Treatment as UsualActive comparatorNot described
Receives: Device: Flow FL-100 tDCS headset

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To determine clinical efficacy of a 10-week course of home-based tDCS for bipolar depression in terms of depressive symptoms as measured by clinician-rated MADRS score in active and sham treatment arms at week 10

    Measured: From randomisation to the end of treatment at 10 weeks

Secondary outcomes (9)
  1. To assess effects in self-rated depressive symptoms following 10-week course of home-based tDCS between active and sham treatment arms as measured by Quick Inventory of Depressive Symptomatology (QIDS-SR)

    Measured: From randomisation to the end of treatment at 10 weeks

  2. To assess effects in clinician-rated anxiety symptoms following 10-week course of home based tDCS between active and sham treatment arms as measured by Hamilton Anxiety Rating Scale (HAMA)

    Measured: From randomisation to the end of treatment at 10 weeks

  3. To assess effects in self-rated anxiety symptoms following 10-week course of home-based tDCS between active and sham treatment arms as measured by Generalized Anxiety Disorder questionnaire (GAD-7)

    Measured: From randomisation to the end of treatment at 10 weeks

  4. To assess effects in self-rated quality of life following 10-week course of home-based tDCS between active and sham treatment arms as measured by EQ-5D-5L questionnaire

    Measured: From randomisation to the end of treatment at 10 weeks

  5. To assess effects in clinician-rated depressive symptoms at 6-month follow up between active and sham treatment arms as measured by clinician-rated MADRS

    Measured: 6 months post randomisation

  6. To assess effects in self-rated depressive symptoms at 6-month follow up between active and sham treatment arms as measured by QIDS-SR

    Measured: 6 months post randomisation

  7. To assess effects in clinician-rated anxiety symptoms at 6-month follow up between active and sham treatment arms as measured by HAMA

    Measured: 6 months post randomisation

  8. To assess effects in self-rated anxiety symptoms at 6-month follow up between active and sham treatment arms as measured by GAD-7

    Measured: 6 months post randomisation

  9. To assess effects in quality of life at 6-month follow up between active and sham treatment arms as measured by EQ-5D-5L

    Measured: 6 months post randomisation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Apr 2026
  2. Study start24 Apr 2026 (estimated)
  3. Primary completion30 Apr 2027 (estimated)
  4. Study completion30 Nov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
212 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07556692
Sponsor's protocol ID
IRAS 348113
Other IDs
NIHR167361
Acronym
BDEP
Status last verified
Apr 2026
First submitted
22 Apr 2026
Last updated
29 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Deidentified individual participant data and the data dictionary will be made available on request to academic researchers. The Statistical Analysis Plan is available in the Supplementary Materials. A data request and brief analysis plan will be required in accordance with Ethics Committee requirements. These will be reviewed by the lead, study steering committee and study sponsor. A data transfer agreement (DTA) will have to be completed prior to any data being shared. Following completion of the DTA, data will be shared as password-protected files. Data sharing will abide by the rules and policies defined by the sponsor, relevant institutional review boards, and local, state and federal laws and regulations. Rights and privacy of individuals participating in the research will be protected at all times. Approval will not be provided for commercial use of the data.

Publications

  • Lagerberg PJ, Woodham RD, Selvaraj S, Lajmi N, Hobday H, Sheehan G, Ghazi-Noori AR, Rizvi M, Kwon SS, Orhii P, Machado-Vieira R, Soares JC, Young AH, Fidalgo AR, Rezaei H, Fu CHY. Acceptability of active and sham home-based transcranial direct current stimulation in major depression: mixed methods qualitative analysis in a randomised controlled trial. Ann Gen Psychiatry. 2025 Dec 4;25(1):1. doi: 10.1186/s12991-025-00607-4.

    PubMed 41345653
  • Rezaei H, Woodham RD, Ghazi-Noori AR, Ritter P, Bauer M, Young AH, Bramon E, Fu CHY. Acceptability of home-based transcranial direct current stimulation (tDCS) in bipolar depression: thematic analysis of individual views. BMC Psychiatry. 2025 May 26;25(1):549. doi: 10.1186/s12888-025-06948-4.

    PubMed 40420071
  • Ghazi-Noori AR, Woodham RD, Rezaei H, Sharif MS, Bramon E, Ritter P, Bauer M, Young AH, Fu CHY. Home-based transcranial direct current stimulation in bipolar depression: an open-label treatment study of clinical outcomes, acceptability and adverse events. Int J Bipolar Disord. 2024 Aug 20;12(1):30. doi: 10.1186/s40345-024-00352-9.

    PubMed 39162912
  • Woodham RD, Selvaraj S, Lajmi N, Hobday H, Sheehan G, Ghazi-Noori AR, Lagerberg PJ, Machado-Vieira R, Soares JC, Young AH, Fu CHY. Home-based transcranial direct current stimulation for major depressive disorder: 6-month follow-up from randomised sham-controlled trial and open-label treatment phases. J Psychiatr Res. 2025 Jun;186:23-32. doi: 10.1016/j.jpsychires.2025.03.047. Epub 2025 Mar 26.

    PubMed 40209536
  • Woodham RD, Selvaraj S, Lajmi N, Hobday H, Sheehan G, Ghazi-Noori AR, Lagerberg PJ, Rizvi M, Kwon SS, Orhii P, Maislin D, Hernandez L, Machado-Vieira R, Soares JC, Young AH, Fu CHY. Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial. Nat Med. 2025 Jan;31(1):87-95. doi: 10.1038/s41591-024-03305-y. Epub 2024 Oct 21.

    PubMed 39433921
  • Woodham RD, Rimmer RM, Young AH, Fu CHY. Adjunctive home-based transcranial direct current stimulation treatment for major depression with real-time remote supervision: An open-label, single-arm feasibility study with long term outcomes. J Psychiatr Res. 2022 Sep;153:197-205. doi: 10.1016/j.jpsychires.2022.07.026. Epub 2022 Jul 8.

    PubMed 35839661

Questions about this trial

What is this clinical trial studying?

A study testing Flow FL-100 tDCS headset in people with Bipolar Disorder (BD), run by King's College London at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 29 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Professor Cynthia Fu (0207848832, cynthia.fu@kcl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To determine clinical efficacy of a 10-week course of home-based tDCS for bipolar depression in terms of depressive symptoms as measured by clinician-rated MADRS score in active and sham treatment arms at week 10 (time frame: From randomisation to the end of treatment at 10 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07556692, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2026.

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