University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Primary Care


Dr Tom Colletti, DHSc, MPAS, PA-C, DFAAPA




Behavioral health disorders, particularly depressive disorders, are among the most common diagnoses in the military population. Depression poses unique challenges to military readiness to include fitness for deployment, participation in field training during treatment stabilization, and potential medical disqualification from military service. Current medical treatments for depressive disorders can have significant side effects such as weight gain, chronic headaches, or increased suicidality. Some of these adverse effects can put current servicemembers at risk for decreased duty performance or involuntary discharge. Cranial electrotherapy stimulation (CES) is a relatively safe alternative treatment option for depressive disorders including major depressive disorder (MDD), bipolar disorder, and treatment-resistant depression (TRD). The FDA has cleared various CES devices for the treatment of mood disorders, which are available either via prescription or over-the-counter.


A review of literature using PUBMED search revealed various existing studies ranging from case control studies to randomized sham-controlled studies and meta-analysis.


CES has proven to be a safe treatment with fewer adverse effects than current medical therapies. Evidence concerning efficacy of CES in treating depressive disorders is currently lacking due to limited few randomized controlled trials (RCTs) and case studies found in current literature. Further, several of these studies admit bias, which is difficult to minimize due to the process of selecting participants and the inherent nature of the treatments.


Existing studies demonstrate efficacy in treating depressive disorders. However, further study is warranted; future studies should encompass longer treatment follow up periods, focus on improving quality of RCTs, and eliminate bias where possible.


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