Cranioelectrotherapy stimulation (CES) for alcohol and cocaine abuse and withdrawal
Numerous studies dating back to the 1970s have investigated the efficacy of weak electrical currents in the treatment a variety of mental health problems including anxiety disorders, depressed mood, insomnia and alcohol and drug abuse. Depending on the technique used, these therapies are described as cranioelectrotherapy stimulation (CES) transcranial electrical stimulation (TES). TES is widely used in Germany and other countries in the European Union for the management of alcohol and narcotic withdrawal. CES has been approved by the U.S. Food and Drug Administration (F.D.A.) as a treatment of chronic pain syndromes and anxiety and is widely used to treat both conditions. In my previous post I reviewed evidence for cranioelectrotherapy stimulation (CES) for reducing symptoms of opiate withdrawal. In this post I take a brief look at studies on CES for treating symptoms of alcohol withdrawal.
Review of research findings
In a 7-year prospective study of CES in the treatment of alcohol, drug and nicotine addiction, acute and chronic withdrawal symptoms were diminished, normal sleep patterns were restored more rapidly and more patients remained addiction-free following regular CES treatments compared to conventional psychopharmacological management. CES-treated patients had significantly fewer anxiety symptoms and higher quality of life measures compared to patients treated with prescription medications (Patterson 1984). Findings of several sham-controlled studies suggest that CES may significantly reduce the time needed for abstinent alcoholics and drug addicts to regain normal cognitive functioning following prolonged drug use or drinking (Smith 1982; Schmitt 1984). Regular CES treatments compare favorably with psychotherapy combined with relaxation training and biofeedback in reducing anxiety in patients abusing any substance (Overcash 1999).
In a 4-week double-blind study, 20 depressed alcoholics were randomized to receive 20 CES treatments at 70 to 80Hz, 4-7mA versus sham treatments. Patients who received CES treatments experienced significantly reduced anxiety by the end of the study. No adverse effects were reported (Krupitsky 1991). This finding suggests that CES might provide an effective non-pharmacological alternative treatment of anxiety in alcoholics while avoiding the risks of cross-tolerance and dependence associated with benzodiazepines. In contrast to established therapeutic benefits CES for managing symptoms of withdrawal from alcohol or opiates (my see my previous post), this approach does not facilitate smoking cessation or reduce nicotine withdrawal symptoms. A 5-day sham-controlled study randomized 51 smokers who were motivated to stop smoking to daily CES (30 microA, 2-msec, 10Hz pulsed signal) versus sham-CES (Pickworth 1997). At the end of the study there were no significant differences between CES and sham-CES in daily cigarettes smoked, smoking urges or nicotine withdrawal symptoms.
Infrequent mild adverse effects
A recently published review of safety issues associated with transcranial electrical stimulation found almost no adverse effects in over 18,000 sessions administered to healthy individuals, neurologic and psychiatric patients (Antal 2017). Infrequently reported transient adverse effects include mild tingling and burning sensations, headache and fatigue. The authors commented on 11 documented cases of possible mania induction in individuals diagnosed with depression however these cases could not be definitively linked to TES because of the small number of individuals enrolled in controlled trials.
There is evidence that regular CES treatments may reduce the severity of withdrawal and reduce time needed for return of normal cognitive functioning, restore normal sleep patterns, and reduce anxiety in the early stages of abstinence in individuals who abuse cocaine or alcohol. CES is widely used in rehabilitation centers and may provide an effective, affordable and practical alternative to conventional medication management of detoxification and withdrawal from alcohol, cocaine and heroin. However, CES does not reduce nicotine craving or withdrawal in individuals who are trying to stop smoking. I encourage you to find a therapist who is experienced in the use of CES if you are considering trying CES as part of a recovery program.