Cranial Electrical Stimulation (CES): Brain Therapy

by Mind Alive July 25, 2024

Cranial Electrical Stimulation (CES): Brain Therapy

Cranial electrical stimulation (CES) is a way to use low-intensity electrical current on the head. It's different from other brain stimulation methods. This therapy is used for many health issues, like anxiety, pain, and sleep problems.

The first CES device was made in the Soviet Union in the early 1900s. The Neurotone 101 became the first CES device approved by the FDA in 1978. It was for treating anxiety, depression, and insomnia. CES works by changing brain chemicals and brain waves. This can help with many brain and mental health issues.

Key Takeaways

• Cranial electrical stimulation (CES) is a non-invasive brain therapy that applies low-intensity electrical current to the head.
• CES has been proposed as a treatment for a variety of conditions, including anxiety, pain, insomnia, depression, and more.
• The first CES device was developed in the Soviet Union in the early 1900s, and the Neurotone 101 was the first FDA-approved CES device in 1978.
• CES is thought to work by modulating neurotransmitters and brain wave activity, leading to potential benefits in various neurological and psychiatric conditions.
• CES devices are widely used in the United States, with the Alpha-Stim and Fisher-Wallace Cranial Electrical Stimulator being among the most popular.

Introduction to Cranial Electrical Stimulation (CES)

Definition and History of CES

CES is a way to use low electrical current on the head without surgery. It started from "electrosleep" research in Russia, then grew popular in the USA in the 1960s. People changed its name to CES because it helped with relaxation, not sleep.

The first CES device, Neurotone 101, got FDA approval. This set the stage for more devices to follow. But, there's debate about how CES is regulated by the FDA.

Mechanism of Action

How CES works is still a mystery, but it might change the brain's electrical activity. It could affect the nervous system, brain areas, and even hormone levels.

Studies show CES changes brain activity and affects certain chemicals in the brain. It also changes how brain areas talk to each other.

"Cranial electrotherapy stimulation (CES) is considered investigational in all situations."

CES is being tested for many issues like pain, sleep problems, and depression. It's also being looked at for helping with pain, losing weight, and stopping opioid addiction. But, we need more proof to know if it really helps.

Clinical Applications of CES

Cranial Electrical Stimulation (CES) is used to help with many health issues. It's mainly used for insomnia, anxiety, and depression. Studies have looked into how CES can help with these problems.

But, some studies have issues with design and bias. To fix this, recent reviews focus on well-designed studies with clear results.

CES for Premature Ejaculation

A study looked at CES for premature ejaculation. This issue affects about 30% of men. The study compared CES with a placebo in a clinical trial.

The CES group saw big improvements in symptoms. This was checked using a special questionnaire.

CES for Anxiety and Depression

CES is also used for anxiety and depression. Studies found it helps with depression and anxiety in different situations. It also helps with sleep in older people.

More studies showed CES helps with anxiety and sleep in older adults. It's also used in clinics to help with anxiety and depression.

It's even used in universities to help students with anxiety and depression. CES is also looked at for its cost and how well it works.

CES for Pain Management

CES is also used for pain, anxiety, and sleep issues in people with advanced cancer. It's used in many places, like dentists' offices and jails.

It helps with anxiety in different situations. It's also used to help children with emotional issues and those affected by domestic violence.

Condition	Clinical Applications of CES
Insomnia	Meta-analyses and review articles have demonstrated the efficacy of CES in improving sleep quality among elderly patients with chronic sleep disorders.
Anxiety Disorders	Randomized controlled trials have reported on the impact of CES on preoperative anxiety, pain, and endocrine response, as well as its combination with acupuncture in treating generalized anxiety disorder.
Depression	Studies have shown positive effects of CES in improving depressive symptoms in people with stress, preoperative anxiety in geriatric patients, as well as anxiety and resting-state brain activity.
Pain Management	Research has explored the use of CES in managing anxiety, depression, sleep disturbance, and pain in patients with advanced cancer.
Other Applications	CES has been used in diverse settings such as dental anxiety management, reducing stress in a sheriff's jail population, controlling anxiety in a dental practice, and aiding in the treatment of acute anxiety disorders, as well as for emotional disorders in children, ADHD, and emotional well-being in victims of domestic violence.

CES for Insomnia Treatment

Cranial Electrical Stimulation (CES) is a new way to help people sleep better. It's not a drug. Many studies have looked into if CES can help with insomnia. The results are not all the same.

Randomized Clinical Trials on CES for Insomnia

A study with 57 service members found no big change in sleep time after 5 days of CES. But, another study with 10 people showed CES helped them fall asleep faster.

These mixed results show we need more studies. Some studies look promising, but we can't say for sure if CES works yet. We need more big, detailed studies to understand its effects on sleep issues.

"The inconsistent findings from these randomized trials highlight the need for further research to establish the efficacy of CES for insomnia treatment."

Even with mixed results, CES could be a big help for those who can't sleep well. It's a non-invasive, drug-free option. So, researchers keep looking into it.

CES for Anxiety Disorders

Cranial Electrical Stimulation (CES) is being looked at as a new way to help people with anxiety. Early studies show CES might help reduce anxiety symptoms. But, we need more research to be sure.

Efficacy of CES in Treating Anxiety

A study looked at eight trials with 337 people who had anxiety. It found CES could really help with anxiety, depression, and insomnia. CES was better than nothing at all for easing anxiety.

It worked just as well on its own or with other treatments. The Alpha-Stim device was found to be more effective than fake treatments. But, we need better studies to be sure CES works well for anxiety.

Experts say the current studies on CES for anxiety are not strong enough. They want more studies with placebos to prove CES's effectiveness.

"CES delivers only 50–500 millionths of an ampere, a minuscule amount of electrical current."

Anxiety affects many people worldwide, from 4.8% to 10.9%. Traditional treatments have side effects and safety concerns. CES is seen as a safer option for anxiety, depression, insomnia, and pain.

Research on CES for anxiety is ongoing. It shows promise, but we need more solid evidence. We must look at both the good and bad sides of CES before we can say for sure if it helps with anxiety.

Cranial electrical stimulation (CES) for Depression

Cranial electrical stimulation (CES) might help with depression, but the results are mixed. A 2014 review by Kavirajan and colleagues found no strong studies on depression. They said we need more solid research to see if CES works for depression.

The FDA has approved CES for insomnia, anxiety, and depression. But, the proof for depression is not as strong. The FDA says there's not enough good evidence for CES in treating depression.

Even with mixed results, some studies hint that CES could help with depression. CES can change the brain's electrical activity. This can make mood and thinking better. It also boosts neurotransmitters and hormones like serotonin and beta-endorphins, which help with mental health.

So, CES's role in treating depression is still being studied and talked about. Some early results look promising. But, we need more big, well-done studies to really know if CES is safe and works for depression.

CES for Post-Traumatic Stress Disorder (PTSD)

Cranial electrical stimulation (CES) might be a new way to help people with post-traumatic stress disorder (PTSD). Studies show CES could be useful but we need more research. This is because the current studies are not enough.

Researchers have looked into how CES can help with PTSD symptoms like anxiety, sleep problems, and feeling sad. The Department of Veterans Affairs says doctors can use CES for PTSD. But, we need more studies to be sure it works well.

Research on CES for PTSD Symptoms

Studies on CES for PTSD have found some good things:

• CES can help with anxiety and sleep issues, which are big problems for people with PTSD.
• Vets who tried CES said it made them feel calmer and sleep better.
• CES is used with other treatments like talking therapy and medicines, and some people got better.
• The Department of Veterans Affairs says it's okay to use cranial electrical stimulation for PTSD, but we need more proof it works.

Even with these good signs, we don't know much about CES for PTSD. We need bigger studies to see if it really helps. This would tell us if it's a good way to treat PTSD without using drugs.

"Tens of thousands of Iraqi and Afghan veterans suffer from post-traumatic stress disorder (PTSD), and drug therapy has been ineffective, triggering an increase in substance abuse, violent behaviors, and suicide rates among veterans."

CES and Pain Management

Cranial Electrical Stimulation (CES) might help manage pain, some studies say. A VA study tested CES with other treatments for chronic pain. It found a drop of 1.0 points in pain ratings.

But, we don't have much proof that CES works for pain. We need more studies to know for sure. Researchers looked at many studies and found 28 that were good to use.

These studies looked at different kinds of pain and mental health issues. But, they had some problems. None were blinded, which can lead to biased results.

Also, the studies were small, with most having less than 30 people. Still, some studies showed CES might help with pain. But, the results were mixed in other studies.

Cranial electrical stimulation therapy (CES) is still being studied for many conditions, including chronic pain. The FDA has approved some devices for use. In 2019, they approved a new device for stomach pain in people with irritable bowel syndrome.

We need more good research to understand how CES can help with pain. This will help us know its benefits and limits.

Other Potential Applications of CES

CES has been studied for many health issues like insomnia, anxiety, and depression. It's also looked at for helping with brain injuries and making the brain work better.

CES for Cognitive Enhancement

CES might help healthy brains work better. It could change how the brain and nerves work. This could make people more alert, better at controlling their movements, and help them manage their feelings.

CES for Traumatic Brain Injury

CES could help people with brain injuries from accidents. It might make the brain work better by changing how it functions. This could help with thinking, feeling, and acting after a brain injury.

Studies are looking into how CES can help with brain injuries. They want to see if it can make people think and feel better. So far, the results look good, but we need more research.

Application	Proposed Mechanisms	Potential Benefits
Cognitive Enhancement	Modulation of central and peripheral nervous system activity Alteration of resting-state and limbic system activity Affecting neurotransmitter and hormone release	Improved vigilance Enhanced perceptuomotor control Increased situation awareness Better emotion regulation
Traumatic Brain Injury	Modulation of nervous system activity Alteration of brain activity Affecting neurotransmitter and hormone release	Improved cognitive function Enhanced emotional well-being Better behavioral outcomes

Research on CES for brain injuries and making the brain work better is promising. But, we need more studies to know how much it helps and how to use it best. Always talk to a doctor before trying CES to make sure it's safe and right for you.

Regulatory Status and FDA Approval

The U.S. Food and Drug Administration (FDA) has changed how it looks at cranial electrical stimulation (CES) devices. It puts devices into three classes, with Class III needing the most checks.

Before, CES devices were seen as Class III. But now, the FDA says CES devices for anxiety or insomnia are Class II. This means they have less rules to follow. They need to do some tests and follow certain rules about how they are labeled.

But, CES devices for depression are still Class III. This means they need a lot of testing before they can be sold. The companies making these devices must show they are safe and work well.

The FDA changed its view on CES devices for anxiety and insomnia after looking at new info. They looked at the good and bad sides of these devices. They listened to over 300 comments before making their decision.

The new rules help keep patients safe while also encouraging new ideas in CES devices. Now, companies making CES devices have to follow new rules or do a lot of testing, depending on what they want to use their devices for.

Popular CES Devices on the Market

The market for cranial electrical stimulation (CES) devices is growing. Many options are available in the United States. These devices differ in how they work, where they place electrodes, and their price. They meet different needs and likes.

The CES Ultra from Neuro-Fitness, LLC is a popular choice. It's FDA-cleared for treating anxiety and insomnia and costs $299.00, down from $379.00. It's supported by over 100 studies, including a Harvard School of Public Health Meta-Analysis.

The Alpha-Stim M and Alpha-Stim 100 from Electromedical Products International, Inc. are also well-known. They help with anxiety, depression, and pain.

The Fisher Wallace Stimulator from Fisher Wallace Laboratories, Inc. and the Caputron MindGear from Caputron Medical Products, LLC are also popular.

CES Device	Manufacturer	Price (USD)	FDA Clearance
CES Ultra	Neuro-Fitness, LLC	$299.00	Anxiety, Insomnia
Alpha-Stim M	Electromedical Products International, Inc.	$795.00	Anxiety, Depression, Pain
Alpha-Stim 100	Electromedical Products International, Inc.	$695.00	Anxiety, Depression, Pain
Fisher Wallace Stimulator	Fisher Wallace Laboratories, Inc.	$699.00	Anxiety, Depression
Caputron MindGear	Caputron Medical Products, LLC	$649.00	Anxiety, Insomnia

These CES devices have many features and help with different conditions. They offer relief for anxiety, insomnia, and depression. The CES market is growing, giving more people a chance to try this brain therapy.

Safety and Side Effects of CES

Cranial Electrical Stimulation (CES) is safe and well-liked. It uses a tiny electrical current. This makes it a safe way to help people.

Side effects are rare and mild. They might include a little tingling or discomfort where the electrodes go.

Research shows CES devices like the Alpha-Stim have been tested a lot. Over 100 studies support their use since 1981. They are approved for treating anxiety, insomnia, and pain. In some countries, they are also approved for depression.

• Alpha-Stim can help with anxiety right away, and the effects last with regular use.
• It can help with insomnia in 2-3 weeks, but it might take longer for some people.
• Alpha-Stim can help with pain right away and gets better with more treatments.
• Depression can start to get better in 3 or more weeks with Alpha-Stim, and some people feel better in days.

CES is safe to use with other treatments and medicines. It's not addictive. It's great for people who are hard to treat. This includes the elderly, those with chronic conditions, and those who don't want to use drugs.

But, people with pacemakers or other implants should not use CES. It could cause problems. Always talk to a doctor before trying CES to make sure it's right for you.

"CES is considered safe in conjunction with other treatment modalities and medications, with no risk of misuse, abuse, addiction, or withdrawal."

We still need to learn more about the long-term safety of CES in kids and pregnant women. But, the research so far shows it's safe and has few side effects. The safety of CES and the side effects of cranial electrical stimulation are mostly good when used correctly.

CES Research Limitations and Future Directions

Cranial electrical stimulation (CES) has shown promise for treating different conditions. But, the research has some big issues. These include not being blinded, small sample sizes, and different ways to measure outcomes. This makes it hard to say for sure if CES works.

We need more studies that are high-quality and controlled. These studies will help us understand CES better and its safety over time. They will look at how it affects children and pregnant women.

Future studies should also look at using CES in new ways. Areas to explore include improving brain function and helping with brain injuries from trauma. Looking into these areas could show us more about what CES can do.

"The existing research on CES is limited by several methodological issues, including inadequate blinding, small sample sizes, and heterogeneous outcome measures."

Even with its current limits, CES research has a bright future. By fixing the methodological issues and looking into new uses, researchers can learn more about CES. This will help us understand its full potential for treating and improving brain health.

Conclusion

Cranial electrical stimulation (CES) is a safe way to help the brain. It might help with sleep issues, anxiety, depression, PTSD, and pain. But, we need more studies to be sure it works well.

CES has helped some people with chronic pain, like those with fibromyalgia. But, the studies had some problems. They had small groups and didn't always keep the results secret. We also need more studies on using CES for PTSD.

CES might also help with thinking skills and for people with brain injuries. But, we need to learn more about how it works and its safety over time. As research goes on, CES could be a new way to help with brain and mental health issues.

FAQ

What is cranial electrical stimulation (CES)?

CES is a way to use low electrical current on the head without surgery. It's like other brain stimulation but different. People use it to help with anxiety, pain, sleep issues, depression, headaches, and more.

How does CES work?

CES sends a low electrical current through the head with special headbands. This current helps change how the brain and nerves work.

What are the proposed mechanisms of CES?

We're still figuring out how CES works, but it might change brain and nerve activity. It could also affect brain waves and the release of brain chemicals.

What are the main clinical applications of CES?

Doctors use CES to help with sleep problems, anxiety, and depression. It's also being studied for PTSD, pain, brain function, and brain injuries.

What is the evidence for the use of CES in treating insomnia?

Studies on CES for sleep issues show mixed results. Some say it helps with falling asleep faster, but others don't see any difference with a fake treatment.

What is the evidence for the use of CES in treating anxiety disorders?

CES might help with anxiety, but we need more solid research. The current studies are not strong enough to prove its effectiveness.

What is the evidence for the use of CES in treating depression?

CES is being looked at for depression, but the results are not clear. There aren't enough good studies to say for sure if it works.

What is the evidence for the use of CES in treating post-traumatic stress disorder (PTSD)?

Some studies suggest CES could help with PTSD symptoms. But, we need more research to be sure.

What is the evidence for the use of CES in treating pain management?

CES might help with pain, but we need more studies to know for sure. The current research is not strong enough.

What are some other potential applications of CES?

CES is also being studied for improving brain function in healthy people. It might help with brain injuries too.

What is the regulatory status of CES devices in the United States?

The FDA used to see CES as a Class III device. Now, it's changed to Class II for some uses and still Class III for others.

What are some popular CES devices on the market?

Many CES devices are available, like the Alpha-Stim M and Alpha-Stim 100. There's also the Fisher Wallace Stimulator and others.

How safe is CES, and what are the potential side effects?

CES is usually safe and well-tolerated. Most side effects are mild, like feeling a little tingle at the electrodes. But, we don't know everything about its safety long-term, especially for kids and pregnant women.

What are the limitations of the current CES research?

The research on CES has some problems. For example, it's not always well-blinded, and the studies are small. We need better studies to understand CES better.

---

Also in Mindalive