I’m interested in trying negative air ionization therapy while I sleep, for depression which is treated with medication but not completely resolved. I also use a CPAP (continuous positive airway pressure) machine, so the air I breathe passes through a filter, over a humidifier chamber, and is heated in the tubing. Would the CPAP affect the negative air ions, and would ionization still be effective?

Most likely, the benefit of negative air ions would be lost while using CPAP.  Our current understanding is that the ionized air has to be inhaled, and routing it through the CPAP machine would likely neutralize it.  That said, there is no evidence that negative air ionization works preferentially during sleep.  Research studies have shown antidepressant efficacy both during sleep and waking hours.

I purchased a negative air ion generator from the CET store almost two years ago and it has improved my life immeasurably. I am less depressive and it seems to have also had the happy “side effects” of significantly reducing my snoring as well as some sinus problems. Obviously anecdotal accounts such as mine are easily discounted, but the clinical research (including that supported by CET) should be harder to ignore. Yet, it seems that almost no clinicians are presenting air ionization to patients as an option and interest in air ionization continues to be mostly confined to a relatively small community of researchers. Do you have any thoughts as to why negative air ionization does not appear to be making much progress in the medical community at large?

Amen and amen. Moving the medical establishment is one obstacle–we are learning that the new generation of psychiatric residents is far more receptive to these ideas than their elders steeped in psychopharmacology, but that portends a generational shift that could take 20 years. Additionally, the FDA provides us no attention, we think because manufacturers are happiest to make a ‘quick buck’ without regulation, and won’t submit (expensive) applications for prescription approval. From CET’s point of view, the major result is the absence of research support that would lead FDA to satisfaction with this significant, non-phamaceutical medical innovation. It is very important for people like you to make their personal findings known and try to jog the system…

How do you respond to the following critique of negative air ion therapy: “…there is no practical way of controlling the ion concentration, which varies with room size, ventilation, machine capacity, and other factors. Therefore, using an ion generator is like taking an unknown dose of a medicine that has unknown effects,” by nutritionist Kurt Butler in A Consumer’s Guide to Alternative Medicine.

This is an excellent point: we do not have precise control of ion dosage. All we really know is the ion flow rate of the generator; all the other factors you list will modulate what the person actually receives (the “dose”). CET’s recommended apparatus was designed to maximize flow to the subject — and thus reduce dose variability — by addition of a grounded wrist strap. The vagaries of dosing aside, however, there are important reasons to seriously consider this new treatment modality:

First, ion generators with high flow rate in close proximity to the subject have produced significant antidepressant results relative to low flow rates. Second, the treatment appears to be innocuous — not only is ion “dose” imperceptible,–no disturbing side effects have been found thus far in controlled clinical trials. To generalize a bit further, consider that a standard “dose” of medication taken in pill form will result in vastly different blood (and brain) concentrations from person to person. Same thing with light therapy: when we measure how many lux a person receives at a light box, it varies significantly between people and indeed within a session for each person.

What is the relationship, if any, between negative air ions and ozone?

There is always some ozonization when negative ions are produced. Depending on the design of an ionizer, the level may be appreciable or negligible. The ionizers that have undergone controlled clinical trials for seasonal and non-seasonal depression produce negligible ozone levels (well below safety cutoffs) that dissipate in the immediate area of the ionizer electrodes. All that said, however, one sometimes reads claims for a specific therapeutic-psychoactive benefit of high levels of ozone. Such claims are unsubstantiated in the scientific literature, and such treatment should be avoided.

How does one choose whether to use light therapy, negative air ionization or dawn simulation for SAD? If one version of light therapy does not work well for you, does that mean the other also will not?

Up till now, post-awakening bright light therapy has been tested most extensively in clinical trials and received professional task force endorsement by the Society for Light Treatment and Biological Rhythms and the American Psychiatric Association, among others. It is quite possible that ionization and dawn simulation will be shown equally effective as bright light, but these are newer developments and the data base for them is smaller. Conservatively, we advise new patients to start with bright light therapy, and then move to (or add) the other methods as follow-up options. Yes, a given patient may respond to one, but not another, of these treatments. Presumably, bright light therapy and dawn simulation act by the same mechanism, and ultimately the choice between them may be based on convenience.

Is there any report of hypomanic episodes with negative air ion therapy?

In formal clinical trials, when side effects were measured, there were no indication of hypomanic episodes. However, clinical cases include a small number of users who have become “wired” (or hypomanic) with negative air ion overdose — when, for example, they leave the ionizer on all night. It is safest to use the method as has been investigated: for 30 minutes after waking or 90 minutes before waking (automatically switched on and off by an electronic timer).