“meditation group” by clients and staff alike. This meditation group was integrated into
a daily schedule along with psychoeducation, cognitive-behavioral therapy (CBT), and
other therapeutic groups.
Two additional 2006 meta-analyses by Smith demonstrated significant improvement in
drug abstinence and cognitive dysfunction from the use of CES.^21 Fibromyalgia, stress
and pain management have also been tested, with promising results.^22 N.b. however
that the Smith monograph has not been peer-reviewed and that Dr. Smith is a consultant
to the industry.
The Smith meta-analyses were summarized as follows by Mischoulon:^23 Each meta-
analysis focuses on a particular treatment indication, as follows:
Drug abstinence: 15 studies, 535 subjects, mean improvement 60%
Cognitive dysfunction: 13 studies, 648 subjects, mean improvement 44%
A 2002 bibliography by Kirsch listed 126 scientific studies of CES involving human
subjects and 29 animal studies. An estimated 145 human studies have been completed,
encompassing over 8800 people receiving active CES, but more rigorous controls are
needed. Future studies should target an understanding of the mechanisms or
neurophysiology of both DC and AC methods of neuromodulation, as well as results for a
broad range of mental health conditions, particularly depression, past studies of which
have not been well controlled. Bipolar disorder has not been studied at all, although the
anecdotal evidence is positive.
The Brown et al. II chapter co-authored by Kirsch contains an extensive discussion of the
evidence, which is very promising. It states that there are three small, randomized,
double-blind, sham-controlled studies showing the promise of CES.^24 To the studies
described by Mischoulon, Brown et al. II add a small study of 48 subjects, showing the
effectiveness of CES in reducing assaultive behavior by up to 41%.^25 Only two of the 48
subjects failed to respond to CES.
In a review of the efficacy of various forms of brain stimulation in the treatment of PTSD,
Novakovic et al. found CES to be the most promising because of its demonstrated
efficacy in treating anxiety: “There are no published studies of CES for PTSD. A meta-