Abstract Introduction Cranial electrotherapy stimulation (CES) was first introduced in the early 1900s. CES has been studied and shown to have therapeutic effects for many ailments including anxiety, depression, insomnia, fibromyalgia, headaches, and various types of chronic pain. CES is a neuromodulation tool that involves applying alternating current transcutaneously via electrodes to bilateral areas of the head, most commonly the earlobes. Effectiveness of CES for symptoms of post-traumatic stress disorder (PTSD) has not been well established, but other neuromodulation treatments, including transcranial magnetic stimulation and transcranial direct current stimulation, have been studied with positive benefit. The subsequent case presentations showcase two veterans with a clinically relevant response in PTSD symptoms with utilization of CES.
Case Presentations The first veteran is a 47-year-old male with a past psychiatric history of chronic PTSD, generalized anxiety disorder, and major depressive disorder. This veteran had multiple trials of different SSRIs with sertraline providing the most benefit for his PTSD. His initial PTSD Checklist for DSM-5 (PCL-5) score was 58. With sertraline 200mg daily and weekly trauma-focused cognitive behavioral therapy, his score decreased to 33. With 20 minutes of daily use of the CES device, his PCL-5 score was further decreased to 12. The next case is a 33-year-old female veteran with a past psychiatric history of chronic PTSD, generalized anxiety disorder, and borderline personality disorder whose treatment goal was to avoid medication. Her initial PCL-5 score was 63. Her PCL-5 score decreased to 26 with 30 minutes of daily use of the CES device.
Discussion These cases highlight the possible application of CES for patients with PTSD. Further studies should be conducted to establish CES as a possible evidence-based treatment for PTSD and to categorize what specific symptoms of PTSD that CES may be able to target.
