What are the benefits and harms of cranial electrical stimulation (CES) for adult patients with chronic painful conditions, depression, anxiety, and insomnia?
Cranial Electrotherapy Stimulator, a randomized controlled trial (Ann Intern Med 2018, PMID 29435567) — two trials comparing CES with usual care found no statistically significant benefit for pain or anxiety. Most trials had small sample sizes and short durations. Evidence is insufficient to conclude that CES has clinically important effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia.
Source: Ann Intern Med 2018, PMID 29435567 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Ann Intern Med · 2018 · PMID 29435567 · DOI 10.7326/M17-1970
Current evidence is insufficient to confirm significant benefits of cranial electrical stimulation for most conditions, though a modest benefit for anxiety and depression is possible.
The question
What are the benefits and harms of cranial electrical stimulation (CES) for adult patients with chronic painful conditions, depression, anxiety, and insomnia?
What they tested
The clinical benefit of cranial electrical stimulation (CES) for pain, depression, anxiety, and insomnia is unclear.
How they did it
A systematic review was conducted by searching several databases from inception to October 10, 2017, for randomized controlled trials comparing CES with usual care or sham CES. Studies reporting pain, depression, anxiety, or sleep outcomes in adults were included. Data extraction was performed by a single reviewer and checked by another, with dual independent quality assessment and strength-of-evidence grading.
What they found
Twenty-eight articles from 26 randomized trials were included. Two trials comparing CES with usual care found no statistically significant benefit for pain or anxiety. Fourteen sham-controlled trials for painful conditions had conflicting results. Five trials (four older, one recent) provided low-strength evidence of a possible modest benefit for anxiety and depression compared with sham. Trials for insomnia (n=2), insomnia and anxiety (n=1), or depression (n=3) had inconclusive or conflicting results. Low-strength evidence suggested CES does not cause serious side effects.
What it means
Evidence is insufficient to conclude that CES has clinically important effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia. There is low-strength evidence suggesting a modest benefit in patients with anxiety and depression.
Limitations
Most trials had small sample sizes and short durations. All included trials had a high risk of bias due to inadequate blinding.
The paper at a glance
| Title | Benefits and Harms of Cranial Electrical Stimulation for Pain, Depression, Anxiety, and Insomnia: A Systematic Review |
|---|---|
| Journal | Ann Intern Med |
| Year | 2018 |
| PMID | 29435567 ↗ |
| DOI | 10.7326/M17-1970 ↗ |
| Topic | Sleep, circadian rhythm & stress |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
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Cranial Electrotherapy Stimulator
Supports sleep and psychological wellbeing. Research relevant to this mechanism is indexed on PubMed and linked below; it describes the mechanism rather than this specific product.
Molecules & mechanisms in this paper
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Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What are the benefits and harms of cranial electrical stimulation (CES) for adult patients with chronic painful conditions, depression, anxiety, and insomnia? [Plain-English summary of Ann Intern Med 2018, PMID 29435567, DOI 10.7326/M17-1970]. Magellan Longevity. https://magellanlongevity.com/study/d29435567.html@misc{magellan_d29435567,
title = {What are the benefits and harms of cranial electrical stimulation (CES) for adult patients with chronic painful conditions, depression, anxiety, and insomnia?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/d29435567.html}},
note = {Plain-English summary of PubMed PMID 29435567; DOI 10.7326/M17-1970; Ann Intern Med 2018. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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