As far back as the first century, the Greeks and Romans used the electric eel, a variety of the “Torpedo Fish” for electrical stimulation. The electric eel was used well into the 19th century, even after the invention of electronic stimulation devices. First century writings record placing a live torpedo fish under the feet of a person suffering from gout to ease the pain. There are also reports of placing these fish on people’s foreheads to treat headaches.

Current interest in CES was initiated by Robinovitch, who in 1914 made the first claim for electrical treatment of insomnia. In 1958, the book Electro-Sleep reflected the first serious works on CES. This book inspired research in Europe and in Eastern Bloc countries, as well as in South America, Asia and finally the US. Because the CES equipment used was bulky, inconvenient, and unreliable, CES, like the electric eel, was abandoned in favour of drug therapies.

With the invention of the transistor in the 1960s, small, low-power and reliable CES devices were developed. By 1975 several companies in the US and Europe were manufacturing CES devices for public use. During this time, research on CES was quite active and scientific papers were published. Most studies to date have shown CES as is a reliable method for treatment of depression and sleep disorders and improve cognition in recovering alcoholics. Additional studies have shown CES to be an effective tool in reducing anxiety and improving IQ.


Cranial electrotherapy stimulation (CES) is a US Food and Drug Administration–approved, prescriptive, noninvasive electromedical treatment that has been shown to decrease anxiety, insomnia, and depression significantly. 

Side effects from CES are mild and self-limiting (<1%); these include vertigo, skin irritation at electrode sites, and headaches. 

A functional magnetic resonance imaging study showed that CES causes cortical deactivation, producing changes similar to those produced by anxiolytic medications. Electroencephalographic studies show that CES increases alpha activity (increased relaxation), decreases delta activity (reduced fatigue), and decreased beta activity (decreased ruminative thoughts). 

Neurotransmitter studies revealed that CES increased blood plasma levels of b endorphin, adrenocorticotrophic hormone, serotonin, melatonin, norepinephrine, and cholinesterase. CES also decreased serum cortisol levels. 

CES treatments are cumulative; however, most patients show at least some improvement after the first treatment. Depression can take up to 3 weeks for initial response. Insomnia varies widely with some individuals having improved sleep immediately and others not having improved sleep until 2 months into treatment. 

A trial treatment in the office or clinic can identify those individuals who readily respond to CES treatment. CES can also be used during psychotherapy sessions and with medications, hypnosis, and biofeedback to decrease patient anxiety. 

CES is cost-effective compared with drugs and other devices used in psychiatry. It is easy to use in both clinical and home settings.

( Daniel L. Kirsch, PhDa, *, Francine Nichols, RN, PhDb )

New studies and clinical experience also suggest benefits for:

– Attention deficit hyperactivity disorder (ADHD)
– Obsessive-compulsive disorder
– Post-traumatic stress disorder (PTSD)
– Cognitive dysfunction
– Traumatic brain injury
– Pain
– Enhancing attention and concentration
– Decreasing assaultive behavior

Many people who used CES along with AVE, have reported that they experienced deeper relaxation for prolonged periods of time. In addition to enhancing entrainment, CES increases neurotransmitter production. These neurotransmitters are necessary for information processing, memory, energy level and physical well-being. When our neurotransmitters and endorphins are not produced to necessary levels, it may lead to destructive behaviors and/or the abuse of substances as a substitute for that “natural high”.