CES involves small,
hardly noticeable, electric current pulsed across the patient's head in a
device that can be used at home.
History
It is a common knowledge that the electro-medicine has been
in existence for over a thousand years—in 46 AD, Roman physician Scribonius
Largus recommended his patients stand on a live torpedo fish for the relief of
a variety of medical conditions, including insomnia and headaches. Roman
Emperor Claudius Galen (131 - 201 AD) attached electric eels to his head to
subdue headaches. However, new technological achievements and scientific
development allows to significantly advance the related treatment approaches.
Modern Cranio-Electro Stimulation (CES) started in Russia
around the 1940s as a treatment for insomnia and heaps of research over the
past 25 years has shown that CES not only helps with insomnia but it diminishes
anxiety and enhances cognition and memory capacity and may even help recovering
alcoholics and drug addicts.
The treatment of anxiety and depression with CES began in
the United States in the early 1960s and it is currently routinely prescribed
by thousands physicians and mental health practitioners in the US and Canada
for a variety of brain-related psychiatric conditions, although it has yet to
achieve full acceptance as a mainstream medical treatment. This is probably
because sufficient information has not been made available to the majority of
medical practitioners regarding the safety and efficacy of CES and the
pharmaceutical industry spends a great deal of money every year promoting the
use of medications instead of such alternative therapies as CES.
While there are over 150 published scientific research
studies on the use of CES. The overwhelming majority of these studies support
the safety and efficacy of CES in the treatment of a number of psychological
disorders; particularly anxiety, depression and insomnia. Yet the majority of
Canadian physicians in general medical practice are simply unaware of them. Unlike
pharmaceuticals, there is no large industry promoting CES to physicians.
While CES is FDA-approved solely for the treatment of
anxiety, depression and insomnia, there is scientific data showing promise in
the treatment of other conditions such as pain, tension/migraine headaches,
fibromyalgia, and substance dependencies (i.e., may reduce symptoms associated
with alcohol, drug or tobacco withdrawal), as well as for calming agitated and
aggressive patients with neuropsychiatric conditions.
For those who are conjuring up images scary doctors and
straightjackets, don’t worry. This has nothing to do Electroconvulsive therapy
(ECT)—electroshock therapy, where medical professionals administer an electric
shock to the brain like something in a 50’s shock film. Cranial electrotherapy
stimulation is a very gentle treatment, with a minor pleasant buzz-like
feeling, which you control, and which you can do yourself.
Mechanism of action
The exact mechanism of action of CES remains unclear but experts
suggest that CES reduces the emotional stress, which is considered as being a
main cause and substantial trigger for numerous emotional disorders. The
proposed mechanism of action for CES is that the pulses of electric current
increase the ability of neural cells to produce serotonin, dopamine DHEA
endorphins and other neurotransmitters stabilizing the neuro-hormonal system.
It has been proposed that 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. Computer modeling suggests
that current of similar magnitudes maybe induced in both cortical and
sub-cortical regions. The prediction that CES induced current intensities in
the sub-cortical structures are not sufficiently decreased from the cortical
structures is potentially clinically meaningful.
It has been suggested that the current results in an
increase of the brain's levels of serotonin, norepinephrine, and dopamine, and
a decrease in its level of cortisol. After a CES treatment, users are in an
"alert, yet relaxed" state, characterized by increased alpha and
decreased delta brain waves as seen on EEG.
Soroush Zaghi et al. published an article in the journal The
Neuroscientist, finding that CES increases the production of serotonin, GABA,
and endorphins. These neurochemical changes theoretically explain any practical
positive effects that are experienced from CES.
Note that most cranial
electrotherapy stimulators are limited to 600 µA. To put this into perspective,
it takes one-half of an ampere to light an ordinary 60 watt light bulb. To
truly compare the work done per second by these two different currents, we must
multiply the currents by the respective voltages that drive them. The product
of current x voltage is a measure of the rate of generation of energy, and is
referred to as the power output. By definition, when a device outputs one
ampere of current with a one volt driving force, the power output of the device
is one watt. Therefore a device producing a maximum output of 600 µA is limited
to about 11,000 times less power than the light bulb: (600/1,000,000) amperes x
9 volts = 0.0054 watts. Some people do not even feel this amount of current.
What does CES feel
like?
Applied to the ear lobes or to the mastoid, just behind the
ear, CES causes the patient to experience nothing more than a faint tingling
sensation. As the treatment continues, most patients begin to feel less
anxious, less distressed, and more relaxed and, yet, mentally alert and focused.
Patients with positive response to CES generally sleep better and report
improved concentration, increased learning abilities, enhanced recall and a
heightened state of well-being after one or a series of CES treatments. Most
people can resume normal activities immediately after treatment. Some people
may experience a euphoric feeling, or a state of deep relaxation that may
temporarily and minimally impair their mental and/or physical abilities for the
performance of potentially hazardous tasks, such as motor vehicle operation. In
some cases, this may last for up to several hours after treatment. Users may do
other things during treatment such as read, watch TV, engage in conversation,
or work on a computer.
CAUTIONARY NOTE: Until
you have experienced CES for yourself and are certain of how you will react to
treatment, it is best that you do operate a motor vehicle or other motorized
equipment or engage in potentially hazardous activities immediately after
treatment.
Most patients are left feeling relaxed and alert after a CES
session— in what psychologists call an “alpha state”. This state differs from
pharmaceutical treatments in that people report feeling that their bodies are
lighter and more relaxed and their minds more alert and clear. The results tend
to be cumulative and lasting.
Regulation
In the United States, CES technology is classified by the
Food and Drug Administration as Class III medical devices and must be dispensed
by or on the order of licensed
healthcare practitioners, i.e. a physician, psychiatrist or nurse practitioner;
psychologists, physician assistants, and occupational therapists who have an
appropriate electrotherapy license may prescribe CES, dependent upon state
regulations.
As a result of the 1976 Medical Device Amendments,
manufacturers who prove both safety and efficacy may enter the market, with FDA
clearance, utilizing the 510(k) process instead of the premarket approval
process, at this time. There are currently three major manufacturers of cranial
electrotherapy stimulation (CES) in the United States and one in Canada.
The Neurological Devices Panel rejected 2012 a call from the
CES manufacturers to setup less restrictive category for CES.
Advocates for the less restrictive Class II category, which
requires general or special postmarket controls without PMA, include Jerrold
Rosenbaum, MD, Chief of Psychiatry at Massachusetts General Hospital in Boston.
“I support CES receiving Class II status in light of its safety in fairly
extensive use and positive results observed by many who use it,” Rosenbaum
related in a correspondence included in one manufacturer’s petition. “This
appears to be a very low risk device without serious side effects.”
Correspondence supporting the lower-risk classification was
also received from the Department of the Army. Colonel Dallas Hack, MD,
Director of the US Army Combat Casualty Care Research Program, indicated, “CES
devices have been prescribed for the treatment of soldiers and veterans with
neuropsychiatric conditions who do not respond to psychotropic medications or
do not comply with prescriptions.”
Although common adverse effects of the devices, such as skin
irritation, headaches, and dizziness, were generally found to be tolerable and
were characterized by the advisory panel as “appropriate risks,” the Agency
report also noted the potential risk of seizure “or other adverse effects from
electrical stimulation of the brain.”
The principle safety concern, however, is the worsening of
the condition being treated if the device is not effective. “A key concern
stemming from our review of the literature,” the FDA reported, “is that use of
CES in lieu of more effective, proven therapies may present undue risk to
patients whose psychiatric conditions may worsen if untreated.”
In any case, you can legally apply the CES on yourself at
home, but the procedure should be prescribed by the certified professional, and
it should be accompanied with the documented treatment plan.
Equipment
The CES-Ultra is a small
device that you can use yourself to treat depression, anxiety and insomnia. It
looks a bit like an iPod,
so you can take it anywhere and use it whenever you. It sends microcurrents
(similar to levels within the brain) through the brain at a variety of
frequencies. This patented waveform normalizes the electrical activity of the
nervous system producing a calming yet focused effect. Effects can be seen
after a single treatment, and repeated treatments increase the strength and
period of these effects. CES-Ultra technology can be beneficial to patients
with pain, anxiety, depression and sleep disorders.
The microcurrent produced by the Fisher Wallace stimulator provokes a natural extension of
your brain’s electricity, affecting your brainwaves and providing a slight
energy boost to your central nervous system. Therefore it increases the
feel-good factor, and inhibits feelings of depression and anxiety. The Fisher
Wallace stimulator is available to the public for home use (by prescription
only), and the results of research into its efficacy and safety is easily
obtainable. The many benefits of CES devises tend to be cumulative in nature
and gradually reveal themselves over a period of 1 to 3 weeks. Research
demonstrates that CES produces a mild stimulation in the hypothalamic area of
the brain, resulting in balancing neurotransmitter activity (in particular Beta
Endorphin and Norepinephrine). The effects achieved are similar to that of a
"runner's high."
Sources and Additional
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