Safe Effective Nondrug Treatment of Chronic Depression: A Review of Research on Low-Voltage Cranial Electrical Stimulation and Other Adjunctive Therapies

Although clinical practice guidelines tend to emphasize pharmacological treatments for chronic depression, safe and effective nondrug treatments are available. This article reviews three decades of research at the Shealy Institute on nonpharmacological treatments for chronic depression in chronic pain patients via low-voltage electrical stimulation and other adjunctive therapies. More than 30,000 chronically depressed patients have been treated with cranial electrical stimulation at 1 to 2 mA at 15,000 Hz, modulated at 500 and 15 Hz. Approximately half of patients treated with this approach experienced marked clinical improvement. When combined with photostimulation at 1 to 7 Hz, 85% of patients improved adequately without use of antidepressant drugs and without complications. Magnesium replacement and nutrition education are useful adjuncts. This program is cost effective and can be carried out by a nurse practitioner and an assistant. Further controlled clinical research and research on mechanisms of action would strengthen the validity of these findings and increase the application of these therapeutic approaches.