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Cranial Electrotherapy Stimulation (CES) is used in the treatment of anxiety, depression, insomnia, and drug addiction; via a low intensity electrical microcurrent.[1] CES is an alternative to drugs, which attempt to affect the brain via chemical processes. In the United States, CES equipment must be prescribed by a licensed independent provider (i.e., medical psychologist, nurse practitioner, physician or physicians assistant).

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."

How CES Works[]

Research conducted in the 20th century has demonstrated that the brain makes use of electrical activity; thus, 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 behind the ear at the mastoid, or clipped to the upper portion of the earlobe, near to the face. CES treatment promotes an increase in endorphins; note, scientists remain unsure why this occurs. 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.


"Electrotherapy" has been in use for at least 2000 years, as shown by the clinical literature of the early Romanphysician, 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 behind the earlobes was far more convenient, and quite effective.

New Competing Devices[]

Electrical devices in psychiatry have not caught on until recently. With the strong arm of the prescription medicine industry backing medication, and the stigma of electrical devices for use on the brain (which many relate to electroconvulsive therapy ) companies that developed such devices had a difficult time receiving financial support for needed research. Now that public sentiment is beginning to change new electrical devices are emerging for the treatment of psychological disorders such as transcranial magnetic stimulation and vagus nerve stimulation. These devices may prove to be effective, however, the makers of Cranial Electrotherapy Stimulation devices have been experimenting and using electrical devices for years to treat millions of patients.


Most users report a decrease in anxiety during treatment, and many other report a decrease in anxiety as much as two days later. Some users report a euphoric feeling; they report that their bodies feel "lighter", their thinking is clearer, and that they are more creative.

A minority of users require five to ten treatments to achieve any effect.

The FDA has cleared several CES units to be marketed for the treatment of anxiety, depression, and insomnia.


There have been no major complications or negative effects associated with CES. Users who feel discomfort while using CES suffer no long-term difficulties. Temporary side effects may include a headache, lightheadedness, or skin irritation at the electrode site. Also, rarely paradoxical reactions may occur including excitement, anxiety, sleep problems, or increases in pre-existing depression.[2]

See also[]


  1. Kirsch, DL. A practical protocol for electromedical treatment of pain: cranial electrotherapy stimulation. In: Kirsch, DL, ed. 6th ed. Pain Management: A Practical Guide for Clinicians. Boca Raton, FL: Greenwood Press; 2002: 1-6.
  2. Jones, E. Cranial Electrotherapy Stimulation: A Non-Drug Neuromedical Treatment. GNIF Brain Blogger. December, 2006.

Further reading[]

  • Ambrus, O., & Jedlickova, A. (1980). Comparison of active and placebo effects of electrosleep: Cesko-Slovenska Psychiatrie Vol 76(3) Jun 1980, 172-175.
  • Coursey, R. D., Frankel, B. L., Gaarder, K. R., & Mott, D. E. (1980). A comparison of relaxation techniques with electrosleep therapy for chronic, sleep-onset insomnia: A sleep-EEG study: Biofeedback & Self Regulation Vol 5(1) Mar 1980, 57-73.
  • Demotes-Mainard, J., Philip, P., Jalfre, M., & Vincent, J. D. (1990). Cerebral electrotherapy for hypnotic drug withdrawal: L'Encephale Vol 16(4) Jul-Aug 1990, 265-267.
  • Gibson, T. H. (1983). A comparison of the efficacy of relaxation training and electrosleep therapies as short term treatments of generalized anxiety: Dissertation Abstracts International.
  • Gomez, E., & Mikhail, A. R. (1979). Treatment of methadone withdrawal with cerebral electrotherapy (electrosleep): British Journal of Psychiatry Vol 134 Jan 1979, 111-113.
  • Grunner, O. (1978). Application of magnetic and electromagnetic fields in insomnia: Waking & Sleeping Vol 2(4) Dec 1978, 217-222.
  • Haslam, M. T. (1989). Electrosleep and stress relief: Stress Medicine Vol 5(3) Jul-Sep 1989, 177-181.
  • Paris, D. E. (1987). Cranial electrotherapy stimulation (electrosleep): A psychophysiological evaluation: Dissertation Abstracts International.
  • Photiades, D. P. (1980). A review of some papers on electrosleep therapy in psychiatry: African Journal of Psychiatry Vol 6(1-2) Jan-Apr 1980, 31-34.
  • Ryan, J. J. (1976). Transcerebral electrotherapy effects on mood disturbance in psychiatric patients according to suggestibility level: Dissertation Abstracts International.
  • Ryan, J. J., & Souheaver, G. T. (1977). The role of sleep in electrosleep therapy for anxiety: Diseases of the Nervous System Vol 38(7) Jul 1977, 515-517.
  • Schmitt, R., Capo, T., Frazier, H., & Boren, D. (1984). Cranial electrotherapy stimulation treatment of cognitive brain dysfunction in chemical dependence: Journal of Clinical Psychiatry Vol 45(2) Feb 1984, 60-63.
  • Snodgrass, R. W. (1977). Cerebral electrostimulation (electrosleep), alcoholism and personal discomfort: Dissertation Abstracts International.
  • von Richthofen, C. L., & Mellor, C. S. (1979). Cerebral electrotherapy: Methodological problems in assessing its therapeutic effectiveness: Psychological Bulletin Vol 86(6) Nov 1979, 1264-1271.
  • von Richthofen, C. L., & Mellor, C. S. (1980). Electrosleep therapy: A controlled study of its effects in anxiety neurosis: The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie Vol 25(3) Apr 1980, 213-219.