Monthly Archives: September 2016

CES being used in pain clinics

CES units were becoming more widely used in pain clinics at the dawning of the 21st century. The clinics typically do not wait for pain studies to be completed, but simply try CES with their patients to see what effect they can observe, then compare it with their historical experience with those same types of patients. A typical such clinic is one just outside Dallas, Texas. A nursing assistant puts CES electrodes on patients as they enter the waiting room to await their turn with physicians or other therapists. The wait can vary from a few minutes to a half hour, depending on the patient load at a given time. The patients complete a 10 point self rated pain score prior to receiving CES. When they are called into treatment by the treatment staff, the CES is removed, the amount of time they were on the device is recorded, as a post CES self rated pain score if obtained.

The clinic has become so enthusiastic about the results, that this protocol has become a permanent part of their core treatment program. They now enthusiastically prescribe CES home units for their large number of patients who now request them, and the staff reports their clinic is much more effectively treating chronic pain than they were previously.

Pain clinic treatment results have been published, however. An interesting CES study was completed in a pain clinic near Bombay, India, in 2001. It was an open clinical trial of CES, used alone as a treatment of pain patients who had been refractory to all other previous efforts of treatment of their pain at the clinic. They were given CES treatments one hour per day, 5 days a week, for three weeks. They were asked to rate their pain level on a VAS scale of 0 to 10, with 10 being the most intense pain. Following treatment their mean self reported pain level had been reduced by 62%. Analyzing the data for individual patients it was found that 15% of the patients did not respond to the treatment, 30% gained total relief, while the remainder of the patients claimed significant relief ranging from 33% to 94%.

PTSD and Cranial Electro Stimulation Therapy

CES as a Viable Treatment for a Growing Problem

With tens of thousands of young Americans returning from a decade plus of war.. Nothing that the Pharmaceutical Companies has done thus far is helping. The problem not only persists, it is growing !!!

ces-stress-trauma

Position Paper on Cranial Electrotherapy Stimulation
Ray B. Smith, Ph.D.

I. Known effectiveness of Cranial Electrotherapy Stimulation (CES) in mental health.

A. Anxiety: 38 clinical studies of anxiety, 21 of which were double blind, showed a mean improvement of 58%, with a range of from 38% to 94% improvement.
B. Depression: 18 clinical studies of depression, 7 of which were double blind, showed a mean improvement of 47%, with a range of from 25% to 80% improvement.
C. Insomnia: 19 clinical studies of insomnia, 7 of which were double blind showed a mean improvement of 62%, with a range of from 37% to 93% improvement.
D. Cognitive Dysfunction: 13 studies of cognitive dysfunction of various kinds, 54% of which were single or double blind, showed a mean improvement of 44%, with a range of from 23% to 86% improvement.

Note: These patients were treated with CES for 45 to 60 minutes a day for 10 to 14 days. They continued to improve for the next 6 weeks once treatment had been discontinued. All of this treatment was medication free, though CES can be used in the presence of medication, and appears to potentiate medication.

II. Theoretical impact of CES in PTSD treatment.

A. PTSD is caused by traumatic memories coming to the fore unbidden, which disrupt the person’s personality and behavior while active.
B. Eliciting the traumatic memory(s) during therapy is necessary but can be a difficult and long drawn out process because the memory can trigger the PTSD response and defeat therapy.
C. CES can prevent the emotional response to traumatic memory while the current is on.2
D. Recalled memories can be deleted from the brain within 3 to 10 minutes from the time they are called up, and other memories inserted if the patient remains calm and does not go into the PTSD response, thus ending the PTSD.

Note: Perhaps the greatest problem of PTSD therapists is the amount of time required to enable the patient to recall the traumatic experience in therapy without triggering a full blown anxiety response. That could be prevented if CES were worn by the patient while the traumatic event was recalled. At that point the memory could be removed from the memory stores and/or replaced by a less traumatic version of the memory.

Presented by cesultra.com

Why Psychiatry needs CES (Cranial Electrotherapy Stimulation)

INSOMNIA

Many patients benefit from improving sleep hygiene and as a treatment for insomnia.

Others may improve using a sleep phase changes or treating the underlying problem such as sleep apnea, medical conditions, alcohol abuse, etc.

For many others, recent pharmacologic treatments prove effective and have minimal side effects. Targeting melatonin receptors is a novel and promising approach.

For many persons, however, existing treatments are ineffective, too expensive, result in side effects or conflict with their desire to avoid medications. Some side effects from medications are very disturbing, such as sleep associated behaviors that result in harm to self or others. For others, there is morning sedation, drug/drug interactions or rebound insomnia. When behavioral interventions are not effective, CES could be considered prior to initiating medications.

ANXIETY

There are many non-pharmacologic interventions for reducing anxiety. Some of these include dietary supplements, acupuncture, meditation, yoga, and exercise. These interventions, however, are not employed by a large segment of society that suffers from anxiety. These persons instead seek medications from their physician to alleviate their suffering. Typical classes of medications for anxiety include the SSRI’s, benzodiazepines as well as the off label use of antihistamines and atypical antipsychotic medications and antiepileptic medications. In addition to the inherent problems with SSRI’s, there are also problems with the other classes of medications. A serious potential side effect of benzodiazepines is their potential for inducing physical and psychological dependence. In addition, withdrawal symptoms can prove life threatening, especially with the shorter acting benzodiazepines like alprazolam. When taken as directed, which is often not the case; this class of medications can result in compromised coordination, slowed reaction time, falls, disinhibition, delirium, and anterograde amnesia.

It is not uncommon to see suicide attempts involving a combination of a benzodiazepines together with alcohol and/or another sedative hypnotic. While buspirone is relatively well tolerated, it has poor efficacy and a 3 to 4 week lag time to have an effect. Medications such as gabapentin are used off label but there is no research to support its efficacy for anxiety disorders. Unfortunately, physicians have begun using the atypical antipsychotic medications to treat anxiety. This class of medications has a large and increasing number of very serious side effects. Recent attention has been focused on their causing metabolic syndrome. They frequently cause extra pyramidal side effects, sedation, elevated prolactin levels and drug/drug interactions. All of these medications should be avoided during pregnancy and used with caution in the elderly. In short, the side effect profile of current pharmacologic treatments for anxiety limits their safe use.

DEPRESSION

There is considerable controversy regarding the efficacy for evidence based treatments for depression. The controversy also involves the risk/benefit analyses of currently approved interventions. While the primary focus has been on medications, similar concerns have been raised regarding certain psychotherapies, transcranial electromagnetic stimulation, vagal nerve stimulation, ECT and herbal and dietary supplements.

Through articles published in the lay press, the general public has been apprised of the controversy involving the efficacy of antidepressant medications. For example, Time magazine recently cited Kirsch’s meta-analysis in PLoS Medicine that found little benefit of antidepressants for most patients as well as Dr. John Krystal’s findings that about 25% of patients did worse on antidepressants than on placebo”. They have been informed about the black box warnings for SSRI’s causing suicidal behaviors. One of the results of this publicity is a growing movement away from all medications to “holistic” or “folk remedies”. In fact, there many patients express fears of taking medications.

There is excellent data and clinical experience however to support the safety and lack of adverse side effects from CES and it should be included in the spectrum of available treatments as it poses very low risk of harm to patients.

Excerpts from “A View from the Trenches” written by Jason Worchel, M.D.

More CES Research – http://www.cesultra.com/research-resources.htm

Balancing the Brain or Cranial Electrical Stimulation With Bob Beck’s Brain Tuner & Bio-Tuner

Electro-therapy got its start during the days of the Roman Empire when Greek physicians had their patients stand on electric torpedo fish as a step to improve health in the first century AD. Scribonius Largus wrote: “For any type of gout a live black torpedo should, when the pain begins, be placed under the feet … in this way Anteros, a freeman of Tiberius, was cured. … Headache even if it is chronic and unbearable is taken away and remedied forever by a live black torpedo placed on the spot which is in pain, until the pain ceases.” And Claudius Galen wrote: “Therefore I thought that the torpedo should be applied alive to the person who has the headache, … and could free the patient from pain … this I found to be so.”

Electricity was harnessed for healing as early as 1747. A professor of experimental philosophy and mathematics in Geneva restored life to the paralyzed arm of a blacksmith using an electric current. Electricity was soon recognized as being a natural part of the life force. It was used extensively for healing until the early part of the 20th Century and the advent of the pharmaceutical industry.

In the Bakken Museum in Minneapolis, there are several models of early devices used to bring about healing by applying electrical stimulation to the brain. In modern times, research started as early as 1903 to help with insomnia. This research was known first as “Electro-sleep” and later as more applications were discovered the term “Cranial Electrical Stimulation” or CES was used.

Robert (Bob) C. Beck, D.Sc. conducted brain research and developed an improved EEG to read brain wave patterns in the 1970’s. When he read in 1983 about Dr. Meg Patterson’s success in helping rock star Peter Townshend overcome his drug addiction using a “Black Box Brain Tuner” he contacted her. These two research pioneers enjoyed several meetings. Patterson was committed to a large corporation so Bob Beck decided to develop his own Brain Tuner. With Bob’s genius, he was able to develop a unit that emitted all the key frequencies simultaneously. These frequencies include a special healing frequency Bob discovered from Russian researchers.

Bob Beck won the John Fetzer Foundation pioneering award for scientific achievement in 1990 for his brain research. His investigation into the workings of the brain and/or his Brain Tuner are included in at least three books:

  1. Super–Learning 2000, Sheila Ostrander and Lynn Schroeder, 1994. ISBN#0–440–22388–1″The implications of this work are stunning,” said physicist Bob Beck, the expert on electromagnetic fields, long employed as a consultant to the Department of Defense. Beck, a close friend of Meg Patterson, was soon swept into an adventure of discovery. He studied all her research and everything he could uncover in the Defense Department. Working with spectrum analyzers and sophisticated equipment, he came up with a device: the Brain Tuner 5+, which broadcasts the frequencies of the three ‘magic’ ranges of neurotransmitters—enkephalins, catecholamines, and betaendorphins. He set up the frequencies in bundles. Instead of sounding one for each neurotransmitter separately, he put 256 frequencies together like a resonating chord of music. His device, smaller than a Walkman, runs on a 9–volt battery and is safe. The Brain Tuner has electrodes on a stethoscope–like headset that fit in the hollows behind the ears. Acupuncture points behind the ear effectively circulate electrostimulation on the ‘Triple Warmer’ Meridian. You wear the device just twenty minutes a day.Double–blind studies were done at the University of Wisconsin on the BT 5+’s capabilities to overcome drug–withdrawal symptoms and it did the job. Studies at both Wisconsin and the University of Louisiana showed it could boost IQ from twenty to thirty points. BT 5+ stimulation appears to enhance neural efficiency, researchers stated.Users report the BT 5+ reduces stress, improves short and long term memory, helps learning, increases energy, improves concentration and reduces pain, anxiety, depression, and sleep requirements.
  2. Mega Brain Power, Michael Hutchison, 1994. ISBN#1–56282–770–7Beth was given anesthesia when she gave birth to her first baby and later found that she had lost part of her memory. She was forced to give up her job in an aerospace plant. Years later a friend gave her a small cranial electrostimulation (CES) device and she began using it. “Almost overnight,” she said, “all my memories started coming back, including everyone’s telephone extensions at the plant. It was uncanny—all these old extension numbers of people I hadn’t thought of in years.”This story, told to me by researcher Bob Beck, Ph.D., provides graphic evidence of a key fact: We have the electric–powered brains. Each of the billions of neurons in our brains is a tiny electrical generator, as complex as a small computer, firing an electrical signal that triggers the release of various neurochemicals and links it with thousands of other neurons.”The Brain Tuner (BT-6) was devised by Dr. Bob Beck. It uses a complex waveform that, according to Beck, produces over 250 frequency harmonics simultaneously—”all known beneficial frequencies for the natural stimulation of the brain’s neurotransmitters.” …Since addiction, withdrawal, and anhedonia are the result of insufficient levels of certain brain chemicals, or undeveloped pleasure centers and pleasure pathways, the most direct way of eliminating them is to restore optimal levels of the brain chemicals, to stimulate the pleasure centers and pleasure pathways. One of the most exciting breakthroughs in the treatment of addiction has been the discovery that stimulating the brain with a minuscule electrical current (cranial electrostimulation, or CES) can cause the brain quickly to pour out large quantities of the neurochemicals that have been suppressed by addictive substances.

    As electrotherapy researcher Bob Beck described it to me, this was originally discovered when scientists analyzed the brains of rats that had been addicted to opiates: The rats that were addicted had been getting so much opiate that the little endorphin factories in the brain would shut down and say, “Look, our body’s got too much of this. Quit manufacturing it.” And it would take anywhere from a week to three weeks before their rats’ brains would begin manufacturing beta–endorphin again. Whereas in the brains of the control rats that had never been addicted, you would find the normal, expected levels of beta–endorphin. And then they would take a third group of addicted rats, cold turkey cut them off of the heroin, clip little electrodes to their ears, and within 20 minutes of electrical stimulation … the rat brain would start showing that the endorphin production had started up again. So, those rats wouldn’t go through withdrawal symptoms!

    This evidence quickly led to the use of CES in the treatment of humans. …

  3. Energy Medicine, The Scientific Basis, James L. Oschman, 2000. ISBN#0–443–06261–7

If the therapist relaxes into the state of consciousness typical of those who practice meditation, therapeutic touch and QiGong, and other methods, it is likely that his or her brain waves will, from time to time, become entrained with the micropulsations of the earth’s field. If the patient is also relaxed, both therapist and patient may become entrained with the earth’s field.There is remarkable documentation for this concept. In 1969, Robert C. Beck began a decade of research on the brain wave activity of ‘healers’ from a wide variety of subcultures around the world (Beck 1986). Beck recorded their electrical brain waves with an electroencephalograph (EEG). All the healers produced similar brain wave patterns when they were in their ‘altered state’ and performing a ‘healing’. Whatever their beliefs and customs were, all healers registered brain wave activity averaging about 7.8–8.0 cycles/second while they were in their ‘healing’ state. Beck studied exceptional individuals who were famous or who had developed reputations as healers, psychics, shamans or dowsers. …

Beck performed additional studies on some of the subjects and found that during the healing moments their brain waves became phase and frequency synchronized with the earth’s geoelectric micropulsations—the Schumann resonance.

(Beck R 1986 Mood modification with ELF magnetic fields: a preliminary exploration. Archaeus 4:48)

Bob Beck’s first Brain Tuner was called the BT5. A later model was called the BT6. The Beck Brain Tuner is now available from SOTA Instruments as the Bio-Tuner, Model BT6pro.

CES (Cranial Electrotherapy) Studies of Cognitive Function

Executive Summary. Thirteen studies, in which a total of 648 patients with various types of cognitive dysfunction were treated with cranial electrotherapy stimulation (CES), were combined statistically in order to get a more confident look at the effectiveness of CES for treating this condition. While many of the studies were of the classic double blind protocol, others used either the single blind or open clinical trial. The result of the analysis showed that the overall effectiveness of CES was 44% improvement.

In most of the studies, cognitive confusion was but one symptom within a larger syndrome. For example, in most of the studies, substance abuse was the presenting syndrome, while in three of the 13 studies, fibromyalgia was the presenting syndrome. And while all presented symptoms of cognitive confusion of some type, it is obvious from the above secondary analysis, that the cognitive dysfunction among the substance abuse patients was very likely of a different, physiological etiology than that of the fibromyalgia patients, who may have been experiencing cognitive distraction due to the stress of the unrelenting pain of their condition.

Researchers earlier received a strong impetus to study CES in substance abuse patients when in the 1970s it was found that the abstinence syndrome, including such features as depression, anxiety and insomnia, was seen to come under control very quickly with CES. Serendipitously it was also discovered that what had up until the 1980s been termed “permanent brain damage” in these patients responded to three weeks of CES treatment by bringing these patients back within the normal functioning range.

A word about the study types. In the open clinical study, the patients know they are being actively treated for their level of cognitive functioning, the clinicians know who is being treated, and the statistician who summarizes the study data also knows, since there is only one group of patients.

In the single blind study, the patients do not know which are getting treated and which are getting sham treatment, but the clinician providing the treatment knows which are the treated patients. In the single blind study, the clinician doing the post study evaluation of the patients is often blinded to treatment conditions when he completes his evaluation. The statistician is usually blinded also, so that he is given two sets of scores to compare, and doesn’t know which group received the treatment. This study design was used earlier on before treatment blinding devices came on stream. In such studies, the treatment was administered sub sensation threshold, in which the clinician turned up the current intensity until the patient just felt it, then turned it back down until the patient said he could no longer feel the stimulation. At that point, the clinician either left the current at that level or turned the unit off (down to, but not including the final click). Because both the patients and the statistician are both blind to the study conditions, some authors have unwittingly published this design as a double blind experiment. But that term is generally reserved for the true double blind experimental design as described next.

The double blind study, the gold standard of science, is usually confined to studies in which neither the patient nor the clinician knows who is being studied. Those designs became available when a double blinding box could be inserted between the patient and the CES device. The double blinding box often had three, four or more settings in addition to a “0” setting in which current flowed freely between the CES unit and the patient. Among the other settings available, some passed current to the patient and some blocked it entirely. The clinician would begin the double blind treatment session by setting all double blinding boxes to the “0” position, would connect the patient to the CES electrodes, turn the current up slowly until the patient signaled he could just feel it, then reduce the stimulus level until the patient signaled that he could no longer feel it. At that point, the clinician set the double blinding box to one of the other settings available and left the patient on the device for 30 minutes to an hour, not knowing who was receiving actual treatment..

Interestingly, in a good double blind experimental design, such as was the case in the majority of those reported in the table, the persons who were responsible for measuring or rating patient improvement were also blind as to whom was treated, as was the statistician who was given anonymous groups of data to analyze. Note that, in effect, that makes such studies quadruple blind, but that term is not used in science.

In the crossover design, half the patients get treated the first week or two of the study, while the other half receive sham treatment. In the second half of the study, the formerly treated patients now receive sham treatment while the formerly sham treated patients receive treatment. If the crossover does not involve a sham treatment condition, then the crossover study is treated as an open clinical trial where all patients and staff know who is being treated at each cross of the study. That design is often referred to as a study with “wait in line” controls, in that the patients waiting to begin treatment are tested before and at the end of the waiting period before going into treatment. That is thought to control for environmental factors such as unusual stressors on the 10 O’clock news, any local dramatic weather changes, and so forth.

By Ray B. Smith, Ph. D.