| Alternative/fringe therapies |
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| Claims |
| Electrical stimulation of the scalp can relieve various psychological disorders. |
| Related fields |
| Year proposed |
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| Subsequent proponents |
| See also |
Cranial Electrotherapy Stimulation (CES) is a proposed,[1] but unproven, treatment for anxiety, depression, insomnia, and drug addiction. Proponents claim that CES is an alternative to drugs, but critics claim that the evidence for its efficacy is mixed.[2] In the United States, CES equipment must be prescribed by a licensed independent provider (i.e., medical psychologist, nurse practitioner, physician or physician assistant).[3][4]
Because of an early focus upon sleeping disorders, CES was originally known as electrosleep therapy. CES is sometimes written "Cranial-Electro Stimulation", "NeuroElectric Therapy", and "Transcranial Electrotherapy".
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"Electrotherapy" has been in use for at least 2000 years, as shown by the clinical literature of the early Roman physician, Scribonius Largus, who wrote in the Compositiones Medicae of 46 AD that his patients should stand on a live black torpedo fish for the relief of a variety of medical conditions, including gout and headaches. Claudius Galen (131 - 201 AD) also recommended using the shocks from the electrical fish for medical therapies.
Modern research into low intensity electrical stimulation of the brain was begun by Leduc and Rouxeau in France (1902); in 1949, the Soviet Union expanded research of CES to include the treatment of anxiety as well as sleeping disorders.
In the 1960s and 1970s, it was common for physicians and researchers to place electrodes on the eyes, thinking that any other electrode site would not be able to penetrate the cranium. It was later found that placing electrodes on the earlobes was far more convenient, and quite effective.[5] At present, there are over 125 research studies on CES in humans and 29 experimental animal studies. The overwhelming majority of the scientific research is extremely positive. No significant lasting side effects have been reported. Harvard University School of Public Health, Department of Health Policy and Management found: "The meta-analysis of anxiety showed CES to be significantly more effective than sham (P<.05)."[6]
In 1976, CES was used by Dr. Margaret Patterson[7] to treat drug addiction under the name "NeuroElectric Therapy" and NET.
One meta-analysis purports to show that CES is effective in treatment of anxiety,[8] however that report is critical of the quality of the research that it reviews and the authors conclude that "most studies failed to report all data necessary for meta-analysis. Moreover, in all but two trials, the therapist was not blinded and knew which patients were receiving CES or sham treatment. We strongly recommend that future trials of CES report complete data and incorporate therapist blinding to avoid possible bias."[8]
Proponents claim that since the brain makes use of electrical activity, one can affect mental functions by affecting the organ's electrical activity.
During CES, an electric current is focused upon the hypothalamic region; during this process, CES electrodes are placed on the ear at the mastoid, near to the face. CES treatment promotes an increase in endorphin, though scientists remain unsure why this occurs. Most studies cited as evidence for its effectiveness failed to report all data necessary for meta-analysis.[8]
The current results in an increase of the brain's levels of serotonin, norepinephrine, and dopamine, and a decrease in its level of cortisol. When CES is effective, users are in an "alert, yet relaxed" state, characterized by alpha brain waves.
Electrical devices are not as commonly used in psychiatry as medication, in part due to the stigma of electrical devices for use on the brain (which many relate to electroconvulsive therapy). Other electrical devices that claim to treat psychological disorders are emerging, including devices for vagus nerve stimulation.
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