CES Use in an Adult and Adolescent Outpatient Population

A Clinical Report on CES Use in an Adult and Adolescent Outpatient Population

By Charles McCusker, Ph.D. & Ray Smith, Ph.D.

 This paper reports the clinical results of using Cranial Electrotherapy stimulation (CES) with clients in an outpatient treatment program.  It presents clinical effects of CES treatment.  It does not present a statistical analysis of data.  The typical intervention time ranged from thirty to forty days.

CES has a record of alleviating depression, anxiety, and insomnia.  CES treatment typically consists of small bursts of energy that pulse across the head 100 times per second with electrical anodes place between the cranium and mandible or on the ears.  The CES device is the size of a standard paperback book.  It produces a modified square wave AC current with a 20% duty cycle.  A dial allows the user to raise the stimulation intensity from zero to 1.5 mA (milli-amperes).  A nine volt battery supplies the power.

This study took place in an outpatient treatment program.  The patients had received diagnosis of dysthymia (depressive neurosis) or major depression.  Many had associated sleep and anxiety disorders.  Study subjects received prescription for CES accompanied by psychological testing. They received a pre and post treatment psychiatric evaluation.

Pertinent measures in the psychological testing included the Wechsler Intelligence scales, IPAT (depression), and the STAI (anxiety).  CES intervention included at least one 45 minute session per day.  Many patients also received three weeks of group rational behavior therapy sessions (two to three sessions per week), Some received weekly psychotherapy. Others received no other concurrent therapy.  At the time of this writing, almost one hundred patients have received this treatment.


In most cases a four week term of treatment appears to alleviate both the minor and major depressions.  Minor depressions (dysthymias) usually begin to lift in the first week of CES treatment. Patients often have “good” and “bad” days during this period. Major depressions show much amelioration between the third and fourth week.

Unfamiliar memories often rise to conscious awareness in the first and second weeks of treatment. These may include psychopathological repressions.  This provides an excellent opportunity for therapists to assist a patient in exploring “core issues”.  Rational behavior therapy and individual counseling can both assist integration of now conscious memories.  Cognitive training can offer new methods of dealing with depression, anxiety, stress, and their precipitating situations.

Patients with sleep disorders usually re-initiate a normal sleep cycle. Patients frequently describe a new sense of well being.  They report they no longer think about or dwell upon previously ruminative and bothersome issues and past experiences.  In cases where the patient used anti-depressant or anti-anxiety medication they have successfully eliminated or greatly reduced dosage within the four week period.

Cognitive function, as measured by the Wechsler scales, has shown gains.  These gains exceed the expected test-retest gains.  These gains occurred most often in the Performance area. We have yet to analyze the data for relationships between cognition and levels of depression or anxiety.


CES seems an effective and safe treatment for the amelioration of mood disturbances in depressed and anxious outpatients.  The treatment and recovery from depression and anxiety related disorders seems to follow a predictable pattern of recovery.  Many patients also improved cognitive functioning.  These improvements appeared especially in Performance area tasks.

The bibliography refers to many other studies of  CES.  No cases studied to date have revealed any serious abreactions, contraindications, or side effects to CES treatment.  Clients generally experience significant improvement on psychological measures, including those of depression and anxiety, similar to those in this study.

In addition, the present study measures cognitive changes on the Wechsler scales, and continues to track many patients (up to one year as of this writing).  In the future, this study will include greater statistical analyses of data.

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