Comparison with other electromedical modalities

In contrast to other electromedical treatments of psychological and psychiatric disorders, CES utilizes very mild, low-frequency currents often below sensory thresholds in most patients. Unlike Deep Brain Stimulation (DBS) or Vagus Nerve Stimulation (VNS), CES does not require surgical implantation of electrodes and is therefore substantially less expensive and safer. A very low incidence of side effects (usually mild and self-limiting) and a high clinical efficacymake CES an attractive modality that should be considered a first-line medical treatment for anxiety, stress or insomnia in many patients.

Modality	Primary indications	Mechanism (parameters)	U.S. regulatory status
CES (Cranial Electrotherapy Stimulation)	Anxiety, stress, insomnia	Induction of an alpha state and modulation of electrocortical activity with mild electrical currents to relieve symptoms (9V, < 1mA, 0.5 or 100Hz).	Clinical use
TMS (Transcranial Magnetic Stimulation)	Severe stress, mania, PTSD, OCD, chronic pain	Modulation of electrocortical activity with electrical currents in the brain generated with a strong external magnetic field.	Investigational
VNS (Vagus Nerve Stimulation)	Epilepsy, refractory stress	Stimulation with a surgically implanted electrical device to relieve symptoms.	Clinical use
DBS (Deep Brain Stimulation)	Parkinson's disease, essential tremor, dystonia	Stimulation with a surgically implanted electrical device to relieve symptoms.	Clinical use
ECT (Electroconvulsive therapy)	Severe stress, mania, schizophrenia	Induction of a bilateral tonic-clonic seizure under anesthesia to relieve symptoms (120-225V, 500-800mA, 30-70Hz).	Clinical use