CES vs. tES vs. TMS: How Do They Compare?
TMS vs. CES vs. tES. That’s a LOT of acronyms! Here’s what they stand for: CES Cranial Electrotherapy Stimulation), tES (Transcranial Electrical Stimulation), TMS (Transcranial Magnetic Stimulation). Three powerful therapies with three different applications. How are they similar? How do they differ? And how can you determine which is the right therapy for you?
Whether you’re struggling with insomnia, anxiety or insomnia, there may be a treatment here that could really help.
First, we’ll talk about each therapy individually. Then, we’ll dive into a comparison of the three. Let’s get started!
Cranial Electrotherapy Stimulation (CES)
First on the list: Cranial Electrotherapy Stimulation, also called CES. During a CES treatment, tiny amount of electrical current (microcurrent) pass through the hypothalamus area of the brain, regulating neurotransmitters like serotonin, melatonin and B-endorphins.
CES is an FDA-cleared treatment for anxiety and insomnia. CES devices are considered Class III medical devices for the treatment of depression (a prescription from a licensed practitioner is required.)
When CES originally came to the USA back in the 1960s, they called it “electrosleep.” Researchers in Europe had studied electrosleep for decades in an attempt to find a frequency that would reliably and consistently put patients to sleep. Though they never found that frequency, they discovered that the patients participating in trials started sleeping more deeply and waking up more rested.
From there, further studies attempted to determine whether electrosleep was safe and effective. Researchers confirmed that CES is extraordinarily safe, and does in fact rebalance neurotransmitters. It changes the chemical make-up of the brain in a positive way, promoting less stress, a calmer mind, and better sleep.
The FDA coined the term “CES” for these modern electrosleep devices. Though still largely a mystery to the general public, CES has been extensively studied for its benefits. It is a fantastic therapy for those who suffer from anxiety and insomnia. In some studies, CES performed better than sleeping pills and anxiety medication, providing relief for a vast majority of users.
What’s more, CES poses a very low risk of side effects. It is non-habit forming. In fact, it trains the brain to reach homeostasis and retain a healthy balance of neurotransmitters all on its own. The balance achieved through consistent treatment remains, even after treatment ceases.
“Off label” benefits of CES reported by many patients and studies include:
- More efficient sleep onset
- Elevated mood
- Reduced symptoms of depression
- Reduction in episodes of irrational anger and irritability
- Fewer mood swings
- Improved impulse control
- Calmer patterns of thought
- Heightened mental clarity
- Accelerated learning
- Normalized information recall
- Improved task concentration and focus
CES Pros:
- FDA-cleared treatment for anxiety and insomnia
- Affordable
- Accessible
- Treatments in the comfort of your own home
- Extremely low risk of side effects
- Non-habit forming
- Painless and simple
- Makes measurable changes in the brain
- Widely studied; safe and effective
CES Cons:
- Generally not used to treat depression
- Not studied extensively for neural pathway restoration
Transcranial Electrical Stimulation (tES)
Unlike CES, tES is a relatively new, emerging therapy currently being studied for potential therapeutic effect in neurological disorders. According to Science Direct, ” In this context, transcranial electrical stimulation (tES) aims to enhance adaptive patterns of activity and suppress maladaptive patterns of activity, restoring the equilibrium in imbalanced neural networks in the patient’s brain. Similarly, tES has the aim of enhancing intact human abilities.”
In other words, tES uses electrical current to restore damaged neural pathways, and enhance neural pathways that are intact. This could have potential implications for Alzheimers patients, stroke victims, and even patients with learning and social disabilities.
CES and tES work by the same mechanism and based upon the same principles. They both modulate the central nervous system and make measurable changes in the brain, but they have different applications.
Scientists and doctors are still experimenting with tES to determine what conditions it might treat. On the other hand, CES is proven effective for anxiety and insomnia (and considered possibly effective for many other conditions.)
tES Pros:
- Potential to improve neurodegenerative diseases
- Potential to treat mental health disorders like anxiety, depression and insomnia
- Early trials indicate that the treatment is safe and well-tolerated by most patients
TES Cons:
- tES is still an experimental therapy. There are no established benefits or risks
- tES treatments may need to be performed at a doctor’s office
- tES devices may be relatively complicated and finicky to use
Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation (TMS) is a therapy that uses magnetic fields to stimulate nerve cells in the brain. Unlike tES and CES, TMS uses magnetic fields rather than microcurrent to treat. The treatment is noninvasive and involves wrapping an electromagnetic coil around the forehead, which emits pulses of energy into the brain.
Doctors generally use TMS to treat depression when conventional treatments have failed. TMS must be performed at a treatment center or doctor’s office, and most patients need repeated treatments before they start to feel better. The recommended schedule? Daily treatments, 5 days per week, for 6 weeks. So embarking on a treatment series with TMS is certainly not for the faint of heart.
Although TMS is generally safe for most patients, it does carry a few risks, so it’s important to discuss the therapy with your doctor before starting.
Of the three therapies discussed here, TMS is the most widely-known and widely-used. Insurance companies will sometimes cover TMS treatment for depression when other interventions have failed.
TMS Pros:
- TMS is a widely used and accepted therapy
- Insurance companies may cover treatment
- TMS is FDA-cleared for the treatment of depression
- TMS is very effective for the treatment of depression with a full course of repeated treatments
- TMS is relatively low-risk and non-invasive
TMS Cons:
- Most patients can only get TMS treatment after trying medication and failing to improve
- Treatments generally only take place at a doctor’s office
- Treatment series is intensive, time-consuming and takes up to 6 weeks
- Treatment may be uncomfortable
- TMS may be expensive
Similarities and Differences
Although these therapies may sound similar at first glance, they are very different. CES is best suited for patients with mild to moderate anxiety and/or insomnia who want to treat themselves at home. tES is still an experimental therapy, but it could prove effective for patients with neurodegenerative diseases and conditions. Finally, TMS is best-suited for patients suffering from depression. Depending on the benefits you seek, you can use these guidelines to determine which therapy is best suited to provide them.
Safety Considerations
Though all three of these therapies are considered safe and non-invasive (tES is still in experimental stages) individuals in the following situations ought to exercise caution and work with their practitioner to determine whether CES, tES or TMS would be a good option for you.
- those who are pregnant or breastfeeding
- individuals with epilepsy or a history of seizures
- patients with implanted medical devices
- those taking medication for anxiety, depression or insomnia
- anyone with a medical condition under the care and supervision of a doctor
CES: A Great Place to Start
If you are interested in trying a neuromodulatory treatment like those discussed in this article, we recommend CES as a great place to start. CES therapy is safe, non-invasive, affordable, and accessible via an at-home CES device. Many people can benefit from CES treatment, simply due to its beneficial effects on the nervous system.
Purchase a CES unit from a trustworthy source. Make sure that the device you choose is FDA-cleared, and comes with a warranty or guarantee. Also, take care to follow all the instructions that come with the device. Finally, discuss your decision with your healthcare provider if you have a medical condition before you try CES.
The CES Ultra, offered by Miridia Technology, is a fantastic candidate. It is FDA-cleared, affordable, and comes with a 60-day money-back guarantee. Shipping is free! Additionally, the customer support team is USA-based and very responsive. When you order the CES Ultra from Miridia Technology, a licensed practitioner will review your case and verify that the CES Ultra is a good fit for you before they ship out your unit.
How to Use a CES Device
The CES Ultra comes with electrode pads and ear clips. Simply attach the ear clips to your ears or place the electrode pads as recommended by the device instructions, turn your device on, and set the stimulation level to a comfortable level for you. You don’t have to feel it for it to work—but feeling a gentle tingling is totally fine.
The CES Ultra is very user-friendly. To create a treatment plan, you can follow the instructions of your healthcare provider, or the instructions that come with your device.
We recommend using your CES Ultra 1-2 times per day for 30-45 minutes for the first 2 weeks. Then when you start sleeping better, you can slowly decrease sessions to once per day for 30 minutes. Eventually you may be able to use CES only as maintenance a few times a week, or whenever you feel like you need it. There is no risk of overdose and CES therapy is non-habit forming, so you don’t have to worry about using it too much.
Learn more about CES Ultra here>>
Wishing you Well on Your Journey
We hope this article was helpful and informative, and we wish you well on your journey to recovery and wellness. Did you learn something new about TMS vs. CES vs. tES? Questions? Comments? We’d love to hear from you below!
**This article is written for informational purposes only, and does not constitute medical advice. Always work with a qualified healthcare provider when making decisions about your health and wellness.