Imagine if you could get a boost of creativity, on demand, by sending a small stream of electricity into your brain. The idea may seem far-fetched, but for several years now, devices that are meant to serve this purpose have been available for purchase online, and can be used in the comfort of your home (or studio). Yet these gadgets open up both medical and ethical quandaries, and neuroscientists warn that they could be dangerous when used incorrectly.

In studies from 2016 and 2017, appliances known as Transcranial Electrical Stimulation (tES) devices were shown to cause a short-term increase in specific types of creative cognition, such as a person’s ability to come up with creative ideas. The devices came under scrutiny last week, after professors of neurology at the Georgetown University Medical Center published a review in the Creativity Research Journal. They examined whether or not using tES to increase creative cognition should be seen as a therapeutic treatment, as well as how to regulate these devices, and the potential risks they pose. So what exactly are these devices? And what are the risks?

Originally developed to clinically treat certain forms of anxiety, depression, and chronic pain, tES devices employ two electrodes that are placed on a person’s scalp and send a low-voltage electrical current to superficial layers of the brain. Dr. James Giordano, a professor of neurology at Georgetown University Medical Center and a senior author of the review, noted that the device works like a “volume adjuster” for the activity in the targeted parts of the brain. Researchers found that tES could also be used to cause changes to individuals’ cognitive states, “not only changing a bit of their mood, but their capacity to concentrate, increase vigilance, decrease fatigue, and, in some cases, can even improve things like motor coordination and performance,” he explained.

Given these outcomes, researchers suspected that creative cognition, too, could be increased by tES, because it involves some similar tasks in the brain, like problem-solving. He and his colleagues found that they could use tES, in tandem with neuroimaging technology, to modulate key areas of the brain (specifically, parts of the frontal, temporal, and parietal cortices) that are believed to be involved in creative cognition.

The FDA-approved devices that you’ll find online, for at-home use, emit lower-voltage currents than the tES tech that’s used in clinical settings; they are known as Low Output Transcranial Electrical Stimulation (LOTES) devices. These appliances, Giordano explained, are marketed primarily to increase concentration or alertness. The unit getting the most attention, he said, is manufactured by San Francisco’s Halo Neuroscience; their product, which looks like a pair of large headphones, is geared toward athletes, for use in training to achieve better strength and motor skills. “The device is also seeing some increased attention from other occupational sectors, [which] might suggest that it may be useful in certain work settings, as well,” Giordano added.

The question of whether the administration of tES should be seen as a therapeutic treatment or an enhancement is still up in the air. If a person is deficient in creative cognitive skills—“to the point where it then causes them anxiety, depression, or other forms of psychological unrest or discomfort,” Giordano explained—the use of tES could be seen as a treatment. “In other words, you’re treating something that is obviously viewed as dysfunctional or abnormal and bringing it up to a more functional level,” he explained. If a person is not necessarily deficient in creative cognitive skills, it becomes more complicated.

Giordano drew a comparison between tES and the overuse of erectogenic drugs and stimulants that people take for increased performance or focus. The person isn’t necessarily deficient in their ability to perform sexually or concentrate, but they want to be better in those areas. “In those instances, it’s a thin line between what constitutes a treatment and what constitutes an optimization or enhancement,” Giordano said. Moving forward with regard to tES, he explained, it would be important to develop an accepted consensus on what constitutes viable creativity in specific scenarios.

“Of course, let’s face it, people use a variety of means to enhance their performance—something from Red Bull to 5-Hour Energy to caffeine to alcohol to cigarettes,” Giordano said. “The question here is if, in fact, this is a direct-to-consumer product, do we also see this moving into that range where it’s not lifestyle and occupational performance–enabling, and certainly we see that possibility, if not probability.”

When it comes to the DTC products sold online, Giordano notes that the manufacturers of FDA-approved devices are required to state that they are not to be used for medical conditions; thus, they’re geared towards lifestyle and wellness purposes. Employing LOTES, the electrical output of these devices is much lower than what’s used in clinical settings (under the supervision of a doctor).

Importantly, research has yet to determine how frequently and for how long LOTES devices can be used safely, and how they could affect the developing brains of children. Given that these are electrical devices, they could become harmful when used near water and cause damage to the brain if used excessively—such as using them for long periods of time, like during sleep. Potential risks could also come out of the DIY versions of tES devices that people have begun to make, which could, for example, emit electricity currents that are strong enough to damage the brain.

Given the lack of knowledge regarding the potential detrimental effects of at-home tES devices, a 2017 paper that Giordano contributed to, which was led by biomedical engineer Marom Bikson, proposed a set of standards and regulations. Among them are the warnings that devices should not be used on children without clinical oversight, supervision, and permission; they should not be used by individuals who have a preexisting psychiatric or neurological disorder; and individuals with medical conditions should consult a physician before trying out LOTES. It should be emphasized that if you are going to use such a device, you should follow the manufacturer’s directions and warnings precisely.

These devices are safe when used appropriately, Giordano said, and they come with detailed instructions and precautions, but the concern is that consumers will not heed this advice. “Like with anything else,” he explained, “there is always the possibility for consumer misuse.”