Transdermal Electrical Neurostimulation Therapies in Psychiatry: A Review of the Evidence

Electric current has been used for quite some time in the treatment of mental illness; however, less-invasive usercontrolled transcranial electrical neurostimulation (TEN) devices have begun to enter the market. Developers claim significant positive effects across a variety of physical and mental illnesses, as well as more mundane issues of stress and fatigue. However, the field is young and progressing rapidly, and no review of these claims has been conducted to date. This article summarizes the available evidence for user-controlled TEN devices, divided into three domains: efficacy/effectiveness, usability/safety, and mechanics. Limitations in the existing research base are noted and suggestions for future investigation are provided. [Psychiatr Ann. 2016;46(10):589-593.] The use of electric current to treat psychiatric conditions has a long history. For example, electroconvulsive treatment (ECT) has been in clinical use since 1938. Despite repeated demonstrations of the efficacy and overall safety of ECT, its use is limited due to the invasive nature of the treatment and the potential for side effects.1 More recently, transcranial direct current stimulation (tDCS), which directs current to certain localized brain areas without induction of seizures, has been studied for psychiatric disorders.2 Finally, several techniques have recently been developed that patients can deliver to themselves, and that propose to deliver weak current to superficial cranial nerve sites as a treatment for psychiatric disorders. These techniques have been called by various names including: transdermal electrical neurostimulation (TEN), transdermal electrical stimulation, and cranial Jason Moehringer, PsyD, is a Staff Psychologist, ClearView Communities. Michael B. Knable, DO, DFAPA, is the Executive Director, Sylvan C. Herman Foundation. Address correspondence to Jason Moehringer, PsyD, ClearView Communities, 611 West Patrick Street, Frederick, MD 21701; email: [email protected]. Disclosure: Michael B. Knable is a stock shareholder with MedAdvante, Inc. The remaining author has no relevant financial relationships to disclose. doi: 10.3928/00485713-20160907-04 Jason Moehringer, PsyD; and Michael B. Knable, DO, DFAPA