Electromedicine: CES in the Treatment of Depression, Part 2
Daniel L. Kirsch, PhD; Marshall F. Gilula, MD
Cranial electrotherapy stimulation (CES) is the FDA recognized generic category for medical devices using microcurrent levels of electrical stimulation applied across the head via transcutaneous electrodes for the treatment of anxiety, insomnia and depression. CES treats depression by passing tiny electrical currentssimilar to those found naturally in the bodyimperceptibly through the brain. The microcurrent, delivered in a unique waveform, moves electrons through the brain at a variety of frequencies collectively known as harmonic resonance. This normalizes the electrical activity of the brain as measured by an electroencephalogram (EEG). The patient undergoing CES treatment will often report a pleasant, relaxed feeling of well-being. Improvement is usually experienced during treatment, but may be seen hours later, or even the day after treatment. Depression control is often experienced after two to three weeks of daily treatment. Ear clip electrodes, moistened with an appropriate conducting solution, are applied for 20 minutes to an hour or more on an initial daily basis for 3-6 weeks, followed by a reduced schedule of 2 or 3 treatments a week until the depression is resolved, and then further reduced to an as-needed (p.r.n.) basis.
This article focuses on the meta-analysis of CES studies of depression along with a discussion of individual study designs and outcomes. It is important to note that protocols for some CES studies were poorly designed; inconsistent patient selection and concurrent use of other pharmaceutical modalities rendered the results inconclusive with regard to CES efficacy in treating depression. The authors have carefully selected only valid studies to provide the most complete and accurate meta-analysis of CES depression treatment outcomes.
Early CES Studies In Treating Depression
Rosenthal conducted some of the earliest CES studies of depression when CES was first introduced in the U.S. His work was primarily with psychiatric outpatients, although he sometimes used medical staff as controls. He was basically trying to find out what, if anything, CES treatment would do for his patients, how many sessions it might require, and what level of current it took to get results.1-4
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