Cranial Electrical Stimulation: What Is It, and Should We Use It in Practice?
Authors: Wayne B. Jonas
Journal: Annals of Internal Medicine (2018)

Editorials20 March 2018Cranial Electrical Stimulation: What Is It, and Should We Use It in Practice?Wayne B. Jonas, MDWayne B. Jonas, MDSamueli Integrative Health Programs, Alexandria, Virginia (W.B.J.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-3420 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cranial electrical stimulation (CES) is a form of brain stimulation that uses low levels of alternating current delivered via electrodes placed on the earlobes, occipital area, mastoid processes, or temples. Small studies of CES were done mostly after 1960 and concentrated on depression and insomnia, but this research took a back seat to that of pharmacologic agents, especially after the development of selective serotonin reuptake inhibitors. In 1978, the U.S. Food and Drug Administration (FDA) sanctioned a CES device for depression, anxiety, and insomnia on the basis of claims that predated current FDA regulations (1). The FDA allows more than ...References1. Rosa MA, Lisanby SH. Somatic treatments for mood disorders. Neuropsychopharmacology. 2012;37:102-16. [PMID: 21976043] doi:10.1038/npp.2011.225 CrossrefMedlineGoogle Scholar2. Food and Drug Administration, HHS. Neurological devices; withdrawal of proposed effective date of requirement for premarket approval for cranial electrotherapy stimulator devices. Federal Register. June 2014. Accessed at www.federalregister.gov/documents/2014/06/12/2014-13756/neurological-devices-withdrawal-of-proposed-effective-date-of-requirement-for-premarket-approval-for on 26 December 2017. Google Scholar3. Zaghi S, Acar M, Hultgren B, Boggio PS, Fregni F. Noninvasive brain stimulation with low-intensity electrical currents: putative mechanisms of action for direct and alternating current stimulation. Neuroscientist. 2010;16:285-307. [PMID: 20040569] doi:10.1177/1073858409336227 CrossrefMedlineGoogle Scholar4. Electromedical Products International. Risk assessment–Alpha-Stim. Accessed at www.alpha-stim.com/risk on 15 January 2018. Google Scholar5. Kavirajan HC, Lueck K, Chuang K. Alternating current cranial electrotherapy stimulation (CES) for depression. Cochrane Database Syst Rev. 2014:CD010521. [PMID: 25000907] doi:10.1002/14651858.CD010521.pub2 CrossrefMedlineGoogle Scholar6. Shekelle PG, Cook IA, Miake-Lye IM, Booth MS, Beroes JM, Mak S. Benefits and harms of cranial electrical stimulation for chronic painful conditions, depression, anxiety, and insomnia. A systematic review. Ann Intern Med. 2018;168:414-21. doi:10.7326/M17-1970 LinkGoogle Scholar7. Kirsch DL, Price LR, Nichols F, Marksberry JA, Platoni KT. Military service member and veteran self reports of efficacy of cranial electrotherapy stimulation for anxiety, posttraumatic stress disorder, insomnia, and depression. US Army Med Dep J. 2014:46-54. [PMID: 25830798] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Samueli Integrative Health Programs, Alexandria, Virginia (W.B.J.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3420.Corresponding Author: Wayne B. Jonas, MD, Executive Director, Samueli Integrative Health Programs, 1800 Diagonal Road, Suite 617, Alexandria, VA 22314; e-mail, [email protected]org.This article was published at Annals.org on 13 February 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBenefits and Harms of Cranial Electrical Stimulation for Chronic Painful Conditions, Depression, Anxiety, and Insomnia Paul G. Shekelle , Ian A. Cook , Isomi M. Miake-Lye , Marika Suttorp Booth , Jessica M. Beroes , and Selene Mak Metrics Cited byIn vivo Measurements of Electric Fields During Cranial Electrical Stimulation in the Human BrainEffectiveness of Transcranial Direct Current Stimulation and Pharmacotherapy in Pain Management in Patients with Chronic PainEffectiveness of Transcranial Direct Current Stimulation and Pharmacotherapy in Pain Management in Patients with Chronic PainEfficacy of cranial microcurrent stimulation in patients with tension‐type headache: A prospective, randomised, double‐blinded, sham‐controlled clinical trialSynergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia 20 March 2018Volume 168, Issue 6Page: 446-447KeywordsAnxietyArmed forcesBrainFood and Drug AdministrationInsomniaPosttraumatic stress disorderRandomized trialsSafetySelective serotonin reuptake inhibitorsThyroxine ePublished: 13 February 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...