For Healthcare Providers
A Non-Invasive, FDA-Cleared Neuromodulation Option for Your Patients
Cranial Electrotherapy Stimulation (CES) has almost 50 years of clinical use and FDA clearance for anxiety and insomnia—with a safety profile few psychiatric interventions can match.
Provider Support Includes
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Wholesale pricing and partnership options
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Clinical training and live Q&A sessions
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Patient education and prescribing resources
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Implementation and billing guidance
Understanding the Technology
What Is CES?
Cranial Electrotherapy Stimulation (CES) is a non-invasive, FDA-cleared medical treatment that delivers low-amplitude pulsed electrical current to the brain through electrodes clipped to the earlobes.
Most patients feel nothing beyond a mild tingling sensation, if anything at all. CES devices are portable, battery-powered, and self-administered at home after brief clinical instruction. A typical session lasts 30–45 minutes, with no sedation and no disruption to daily activity.
min Typical session
years Clinical history
studies
CES received FDA clearance in 1978 for anxiety, depression, and insomnia via the 510(k) pathway. A 2019 update narrowed clearance to anxiety and insomnia, reflecting FDA policy changes tied to depression as a treatment category. With over 50 years of legal marketing history and 160+ published human studies, CES has a safety record most newer neuromodulation technologies lack.
What CES is not
CES is frequently confused with other neuromodulation technologies. It is not any of these:
| Technology | Key Difference from CES |
|---|---|
| ECT (electroconvulsive therapy) | Uses current 1,000+ times stronger than CES, requires anesthesia and induces seizures. Hospital-based, for treatment-resistant severe cases. |
| TMS (transcranial magnetic stimulation) | Uses magnetic fields, requires office-based equipment, daily sessions for several weeks. |
| tDCS (transcranial direct current stimulation) | Uses direct current (vs. CES's alternating current). Historically research-only, but as of December 2025 the FDA approved one home-use tDCS device for moderate-to-severe major depressive disorder — a narrow, recent authorization that doesn't yet approach CES's 50-year track record and 160+ published studies. |
How CES Works?
Mechanism of Action
Approximately 42–46% of applied CES current penetrates the skull and reaches brain tissue (Feusner et al., 2012) — a substantial rate, comparable to or exceeding tDCS despite CES using far lower current amplitudes.
Current enters via cranial nerves accessible at the earlobe/mastoid area — the facial, glossopharyngeal, and vagus nerves — which project to brainstem nuclei, then relay to the thalamus (where current concentration is highest), and on to cortical targets including the posterior cingulate cortex, precuneus, supplementary motor area, and prefrontal cortex.
As the brain's primary sensory and arousal relay station, thalamic dysregulation has been implicated in anxiety (hypervigilance via overactive sensory gating), insomnia (impaired sleep-wake regulation), depression, and chronic pain — giving CES a mechanistic rationale across its treated conditions.
Associated increases in serotonin, melatonin, cholinesterase, GABA, norepinephrine, and β-endorphin levels in blood and CSF as well as decreases in cortisol.
- fMRI studies show CES produces cortical deactivation in default mode network regions (PCC, precuneus) similar to patterns seen with SSRIs
- EEG studies show a shift from beta activity (alert states) toward alpha activity (relaxation/sleep transition)
Frequency:
Most studied and clinically used frequencies are 0.5 Hz and 100 Hz. Neurovana CES devices operate at 100 Hz, based on the following evidence:
- Schroeder & Barr (2001), Clinical Neurophysiology: A randomized, double-blind crossover study (N=12) directly comparing 0.5 Hz, 100 Hz, and sham CES with EEG monitoring found 100 Hz produced a "greater overall change" than 0.5 Hz — specifically a larger decrease in beta band power, the frequency band elevated during anxious, hypervigilant mental states.
- Feusner et al. (2012) fMRI data found that network-level connectivity changes in the default mode network (DMN) — the brain network tied to rumination and self-referential worry — occurred only with 100 Hz stimulation, not 0.5 Hz. Both frequencies produced regional cortical deactivation, but only 100 Hz altered DMN connectivity in a way that may reduce rumination and improve engagement with the external environment.
- Kennerly (2006) EEG analysis found CES increases alpha activity while decreasing beta and delta activity — an EEG signature of calm alertness rather than sedation, consistent with what's seen in trained meditators (Banquet, 1973).
The leading mechanistic explanation is that 100 Hz current — oscillating closer to the brain's intrinsic beta frequency range (13–30 Hz) — interferes with pathological neural rhythms (excessive beta in anxiety, hyperactive DMN connectivity) more effectively than the slower 0.5 Hz signal, allowing neural networks to reorganize into more adaptive patterns — which is why Neurovana devices are fixed at 100 Hz rather than leaving frequency to user discretion.
Prescribing & Integration
How CES Fits Into Clinical Care
CES can be used as either adjunctive therapy or monotherapy. It's designed to integrate with psychiatric care, not replace diagnostic evaluation, psychotherapy, medication, or crisis intervention when clinically indicated.
Best Candidates
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Inadequate response to first-line treatment
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Intolerable medication side effects
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Preference for non-pharmacological options
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Comorbid anxiety and insomnia
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Willingness to use consistently for several weeks
Generally Not First-Line For
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Severe presentations requiring immediate safety intervention
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Psychosis
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Acute crisis presentations
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Acute mania
Typical Protocol & Patient Expectations
Daily Use
1–2 sessions, 30–45 minutes each.
Many patients feel benefits right away, but continued use is needed for lasting results
Weeks 1–2
Some early, subtle improvement may occur.
Weeks 3–4
Clinical effects typically begin to emerge.
Weeks 5–8
Continued improvement and stabilization.
From Clinical Practice
A Note From the Founders
When we first started prescribing CES in our practice, we both approached it the way we approach any new tool: skeptically, and through the evidence. What we found surprised us — not because the research was thin (the research was actually quite robust), but because what we saw in our patients actually outperformed what the studies had led us to expect. Our patients were finding real, meaningful relief from CES.
So if you're a provider reading this and wondering whether CES actually works, we can tell you plainly: it does. That has never been the hard part.
The hard part — is accessibility. It's one thing to know what CES can do to help your patients. It's another to actually get it into a patient's hands, get them using it consistently, and keep your practice financially sound while you do it — especially when insurance won't pay for the device itself, and you're left figuring out how to make that work for both the patient and the practice.
What follows in this guide isn't theory — it's the structured model that our practice uses every day to get CES into the hands of the patients who need it, in a way that's sustainable for the practice delivering it. We are sharing it because CES is too effective to remain a niche offering — it belongs in standard care.
We've put everything — the full clinical protocol, the financial models, and the exact billing structure we use — into the guide attached here. If you're serious about bringing CES into your practice, start here.
Tauna Young, FNP-C
Founder & CEO
Tyson Flower, FNP-C
CMO & Clinical Educator
Interested in Offering CES in Your Practice?
Neurovana supports providers with wholesale pricing, training, live Q&A sessions, patient education resources, and implementation guidance.