A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression

Barclay, Timothy H.; Barclay, Raymond D.

doi:10.1016/j.jad.2014.04.029

Cited by 59 publications

(94 citation statements)

References 22 publications

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“…A 1995 meta-analyses of CES therapy raised questions regarding data reporting bias and adequacy of blinding (32). While the use of proprietary waveforms by most CES devices has created an obstacle for independent evaluation of efficacy and potential mechanisms of action, Barclay et al (33)(n=115) conducted a investigation of CES efficacy using the Alpha-Stim device in patients with a primary anxiety disorder and some (unspecified) degree of comorbid depressive symptoms, reported significantly improved depression (p<.001) and anxiety (p<.001) outcomes. However, subsequent studies by Lyon et al (34)(n=167), and Mischoulon et al (35)(n=30) found no advantage of CES over sham on depressive symptoms (all p>.1).…”

Section: Section 2: Review Of Published Randomized Controlled Trialsmentioning

confidence: 99%

Low-Intensity Transcranial Current Stimulation in Psychiatry

Philip

Nelson

Fröhlich

et al. 2017

AJP

110

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Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation (CES) devices – the only category of tCS devices cleared for use in psychiatric disorders - is supported by low quality evidence.

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Section: Section 2: Review Of Published Randomized Controlled Trialsmentioning

confidence: 99%

Low-Intensity Transcranial Current Stimulation in Psychiatry

Philip

Nelson

Fröhlich

et al. 2017

AJP

110

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“…CES has been approved for the treatment of anxiety, depression, and insomnia from Food and Drug Administration in the United States [116]. Clinically, CES can decrease comorbid depression in anxiety disorders [117]. However, the Cochrane library review indicates that methodologically rigorous studies to examine the antidepressant effect of CES in the treatment of acute depression are lacking [118].…”

Section: Brain Stimulation In the Treatment Of Depressionmentioning

confidence: 99%

New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity

2017

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Major depressive disorder is a severe and complex mental disorder. Impaired neurotransmission and disrupted signalling pathways may influence neuroplasticity, which is involved in the brain dysfunction in depression. Traditional neurobiological theories of depression, such as monoamine hypothesis, cannot fully explain the whole picture of depressive disorders. In this review, we discussed new treatment directions of depression, including modulation of glutamatergic system and noninvasive brain stimulation. Dysfunction of glutamatergic neurotransmission plays an important role in the pathophysiology of depression. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has rapid and lasting antidepressive effects in previous studies. In addition to ketamine, other glutamatergic modulators, such as sarcosine, also show potential antidepressant effect in animal models or clinical trials. Noninvasive brain stimulation is another new treatment strategy beyond pharmacotherapy. Growing evidence has demonstrated that superficial brain stimulations, such as transcranial magnetic stimulation, transcranial direct current stimulation, cranial electrotherapy stimulation, and magnetic seizure therapy, can improve depressive symptoms. The antidepressive effect of these brain stimulations may be through modulating neuroplasticity. In conclusion, drugs that modulate neurotransmission via NMDA receptor and noninvasive brain stimulation may provide new directions of treatment for depression. Furthermore, exploring the underlying mechanisms will help in developing novel therapies for depression in the future.

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“…Cranial electrotherapy stimulation (CES) is a noninvasive medical device approved by the Food and Drug Administration (FDA), which delivers a low-intensity (< 1 mA) alternating electrical current to the head. Previous studies have indicated that CES may improve patients’ subjective symptoms of anxiety [8-12], depression [8-10], pain [11, 13], insomnia [9], and posttraumatic stress [9]. CES has also been used for dental procedures as an adjunctive treatment for anxiety [14].…”

Section: Introductionmentioning

confidence: 99%

Nonpharmacological Relaxation Technology for Office-Based Rhinologic Procedures

Marino

Luong

Yao

et al. 2019

ORL

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Background: Office-based rhinologic procedures are increasingly performed to control costs and enhance patient convenience. Adequate management of pain and anxiety is essential for the technical performance of these procedures, in addition to ensuring patient comfort. Pharmacologic agents are often used to manage anxiety and pain. Nonpharmacological adjuncts may be useful for achieving these effects without oral opioids and benzodiazepines. Methods: Charts of patients who underwent office-based rhinologic procedures with the NuCalm system (Solace Lifesciences, Inc., Wilmonton, DE, USA) in combination with local anesthesia were reviewed. NuCalm is a proprietary system that combines cranial electrotherapy stimulation, neuroacoustic software, light-blocking lenses, and topical γ-aminobutyric acid. Patients rated their pain and anxiety before, during, and after the procedure. Results: Twenty-five patients underwent office procedures using the NuCalm system. Preoperative anxiety (2.00) was significantly higher than postoperative anxiety (1.25) according to patient reporting on a 5-point scale (p = 0.005). Preoperative pain (1.83) was not significantly different from intraoperative (2.54) and postoperative pain (2.04, p = 0.054). Conclusions: A variety of office-based rhinologic procedures are technically feasible and can be performed with adequate patient comfort without the use of oral drugs. Adjuncts to pharmacologic agents may enhance pain control and anxiety management and improve patient tolerance of these procedures.

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A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression

Cited by 59 publications

References 22 publications

Low-Intensity Transcranial Current Stimulation in Psychiatry

Low-Intensity Transcranial Current Stimulation in Psychiatry

New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity

Nonpharmacological Relaxation Technology for Office-Based Rhinologic Procedures

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