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Cranial Electrotherapy Stimulation
Cranial Electrotherapy Stimulation (CES) uses a cellphone-sized device that stimulates the cranium and brain with a current that cannot usually be sensed by the consumer (below four milliamps). No serious side effects have been reported. The FDA has recognized CES as a Class III device for treatment of depression, anxiety, and sleep disorders.
Mental Health Implications
A proceeding is pending for Class II status, focused on its use in people recovering from substance use conditions.
Studies and clinical experience also suggest benefits for:
- attention deficit hyperactivity disorder (ADHD),
- obsessive-compulsive disorder,
- post-traumatic stress disorder (PTSD),
- cognitive dysfunction,
- traumatic brain injury,
- enhancing attention and concentration, and
- decreasing assaultive behavior.
Although a prescription is required, CES can be used safely and conveniently in the home, without professional supervision. It can be used adjunctively with most other treatments.
Experts (Brown et al II) caution against the use of CES in pregnancy. Lactation seems not to be an issue. Differential effects on children remain to be tested. Persons with bipolar disorder need to be cautious, since use of CES could worsen the condition, as can also occur with other antidepressants. At a minimum, a mood stabilizer should be considered.
The lack of drug interactions, low incidence of side effects and suggestive findings in small studies require additional research attention and counsel responsible consumer use as the data are being developed.
MHA encourages additional research to determine whether the promise of CES can be fulfilled, without the serious side effects of large-current ECT, Transcranial Electrostimulation ("TES") or deep brain stimulation (higher-intensity forms of brain stimulation, not discussed in this outline). Future studies should target an understanding of the mechanisms or neurophysiology of both DC and AC methods of neuromodulation, as well as results for a broad range of mental health conditions, particularly depression, since most past studies of depression have been small and generally not double-blind. Efficacy with bipolar disorder has not been studied at all, although the anecdotal evidence is positive. A large number of suggested uses remain to be explored.
Promising, but not yet proven. But given minimal side effects, experimentation with CES is a reasonable choice if other treatments prove ineffective or are poorly tolerated.
For detailed information on CES and other treatments, download the full review.