Cranial Electrotherapy Stimulation: Science and Evidence

Introduction:

Cranial Electrotherapy Stimulation (CES) is a non-drug treatment used primarily for anxiety, depression, and insomnia. It can be used as a single modality, or in combination with psychotropic medications, psychotherpy, biofeedback, and other therapies. It essentially consists of applying a very low current that is usually pulsed at 0.5 to 500 Hz to the temples, mastoid processes, or the earlobes. It is not clear at this time if any of the CES devices have a superior waveform however. There are a few devices on the market which the FDA allows to promote for the treatment of anxiety, depression, and insomnia. These devices have also been used "off label" for pain and addictive disorders. CES devices require a prescription in the United States and should only be used under the care of a licensed professional. Usually the devices must be used about 20 to 40 minutes per day, at least a few times per week, for about a month to really appreciate efficiency. Some individuals sense an immediate benefit however, especially when used for anxiety disorders, where the user may feel relaxed but also alert entering into an "alpha state" as demonstrated by the presence of alpha waves on an EEG. CES has been around for many years. The research I have seen concern its efficiency is reliably good, and my clinical experience has also been good. It seems to be reliably safe, however CES may be contraindicated if you have a pacemaker, are pregnant, nursing, or have a seizure disorder. It may also cause some dizziness and nauseaa other side effects but is generally well tolerated.

Science:

CES is actually one of many brain electro-stimulation treatments in psychiatry which also include electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). Like all of these modalities, the exact mechanism of CES is uncertain, however it is postulated to modulate the neurotransmitter systems inducing neurons to produce serotonin, dopamine, neurohormones eg DHEA, and endorphins. Specifically, CES is thought to primarily act on the brain's hypothalamic region, bringing the brain back to pre-pathological homeostasis. By comparison to the other modalities, CES is reliably noninvasive, safe, and inexpensive. All of the treatments, like CES may take from days to weeks to achieve their maximum therapeutic benefit and may be used in combination with psychotropic medications and other treatments. Unlike the other electro-stimulation modalities, CES may be used as a first line treatment, while the others are typically reserved for refractory and severe cases.

Evidence:

While Cranial Electrotherapy Stimulation has been in use for decades, it is currently gaining in popularity, due due to advances in electro-stimulation treatments in general. It was first researched in the Soviet Union in the 1950s, though the idea of ​​using low current stimulation to the brain to injustice sleep dates back to 1902. There are a multitude of studies supporting the use of CES for anxiety, depression, insomnia, addictive and pain disorders. The FDA specifically approves the use of CES for …

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