Vagus Nerve Stimulation Product Comparison: Pulsetto vs Neuvana Xen
- Jon Weingarden
- May 7
- 8 min read
Vagus nerve stimulation (VNS) is becoming a popular method for improving mental wellness. With increasing awareness of the benefits of activating the parasympathetic nervous system, two products stand out: Pulsetto and Neuvana Xen. Both devices aim to support emotional balance, reduce stress, and enhance mental clarity. In this blog post, we present a detailed comparison of these two products, focusing on their features, benefits, and user experiences.
Disclaimer, before we begin: While these products are not FDA regulated medical devices, which some may interpret as implying they don't carry risk, any product and probably particularly medical devices carry a degree of risk. This leads to the second part of my disclaimer - I am not a medical professional. I cannot speak to these risks, I am not claiming any medical expertise about these devices, how they work or medical health. I am not endorsing these items from a medical health or consumer standpoint. I am a professional affiliate of these companies and receive devices at low or no cost, but I do not receive any compensation for this article, nor was I asked to write it. This article simply reflects my perspective as a psychologist, the (small) foundation of information I have attained about this, and my experience as an intermittent user testing these devices. Any determination to use these devices is made solely on your personal account and I would encourage consultation of a medical professional.
Understanding Vagus Nerve Stimulation
Vagus nerve stimulation involves activating the vagus nerve to promote relaxation and alleviate stress. Doing so 'turns on' our parasympathetic nervous system, which is a counterbalance to our sympathetic nervous system - I think of it like a see-saw: we are down regulating our level of arousal that may be unnecessarily activated or chronically left turned-on. See other blog articles on this subject!
This process can impact various body functions, including heart rate, digestion, and emotional regulation. Products like Pulsetto and Neuvana Xen harness the benefits of VNS, providing users with tools to improve their mental health. Research shows that VNS can reduce anxiety levels by up to 30% in some studies, highlighting its potential.
The tech under the hood is nothing new - there are all sorts of electrical stimulation devices for various medical needs, both available to consumers and some only available to medical professionals. However, honing the stimulation for the vagus nerve externally and for direct-to-consumer devices is newer, as well as the specific form-factors - the price tag is presumably the R&D and marketing, not for costly parts.
Pulsetto: Features and Specifications
Pulsetto is a wearable device designed to stimulate the vagus nerve using gentle electrical impulses. It's user-friendly, designed to be worn around the neck, and provides targeted stimulation to improve mood and reduce anxiety.
Notable features of Pulsetto include:
Form-Factor: I found Pulsetto to be comfortable, the biggest drawback is applying and wiping off the gel that improves conductivity for the electrodes. It is size-adjustable and feels solid and sturdy despite being reasonably lightweight.
Multi-level Modes: The device offers five intensity levels, allowing users to customize their experience based on preference and comfort, as well as selecting presets for various symptoms or aspects of wellness such as anxiety, stress, sleep, pain and inflammation (some only available with the monthly paid subscription). Additionally, the length of a session is somewhat adjustable - Pulsetto recommends limits to the number and frequency of sessions.
Long Battery Life: With up to 12 hours of use per charge, Pulsetto is perfect for daily sessions without frequent recharging.
Neuvana Xen: Features and Specifications
Neuvana Xen operates on similar principles but the stimulation is applied in-ear through earbuds that can also play music (integrated with your phone). Xen is a 1-sided devices, applying stimulation to the left-ear, and uses saline spray rather than high-conductivity gel.
Key features of Neuvana Xen include:
Therapeutic Music Integration: Neuvana Xen can be used silently or with the stimulation synchronized with music or soothing audio, enhancing relaxation and mood improvement.
Variety of Programs: While Pulsetto has presets for target symptoms (and I wonder about the accuracy of this), Neuvana lets the user pair two aspects of the electrical stimulation: the nature of the stimulation itself with patterned alterations in amplitude or intensity. Additionally, you can set the intensity across a 25-point scale, letting you dial in just the right amount of stimulation.
Battery: While the Xen was built for wear throughout the day, the battery life ran down surprisingly quickly. It is quick and easy to charge, but would require daily (nightly?) charging if you planned on using it intermittently throughout the day.
Form-Factor: Neuvana Xen is made for extended wear, ensuring comfort during multiple sessions. It requires earbuds, the left one having built-in electrodes to supply 1-sided vagus nerve stimulation. They have a wired connection to a small, palm-sized unit reminiscent of an MP3 player (for those of you who were of the age to have one in their brief period of popularity!). It is very lightweight, so much that it feels a bit fragile or "beta" and while this is likely perception rather than a true measure of quality, it did leave me feeling a bit concerned about it's durability especially for the consumer price tag. I suspect this will change with future models.
Evaluating Effectiveness
Effectiveness can vary for different users, but both Pulsetto and Neuvana Xen offer distinct advantages.
Pulsetto users often praise its simplicity and effectiveness in providing quick stress relief. Many have noted feeling a palpable reduction in anxiety after just a few sessions, with roughly 70% reporting noticeable improvements in their mood and emotional stability.
Meanwhile, Neuvana Xen enjoys positive feedback for its integration of music into the stimulation experience. Users find that this unique combination leads to greater relaxation. Approximately 80% of Neuvana users reported feeling more balanced and less stressed after regular use, emphasizing the effectiveness of the synchronized music feature.
Ultimately, the decision between the two products will depend on individual preferences and needs.
Experiences Shared by Users
User feedback reveals valuable insights into how each product works in practice.
Many Pulsetto users appreciate how easily it fits into their daily lives. They often use it during meditation or while engaging in other relaxation activities. Users report that Pulsetto quickly helps them feel more at ease, especially during anxious moments.
In contrast, Neuvana Xen users frequently mention the music feature as a transformative aspect of their experience. The combination of sound and stimulation creates a holistic approach to managing stress. One user highlighted that the music helped them transition from a highly stressful workday to a calm evening routine, illustrating the practical benefits of this integration.
Both devices have developed a strong following, but individual effectiveness may vary depending on stimulation preferences.
Making Your Choice
Deciding between Pulsetto and Neuvana Xen hinges on your specific needs and preferences for vagus nerve stimulation.
If You Value Simplicity: Choose Pulsetto for a straightforward device focused on effective stress relief.
If You Seek Customization: Opt for Neuvana Xen for a personalized experience that integrates music with stimulation.
Personal Opinion
I personally found both to be effective, and I'm cautious of bias in this opinion because of having more time with the Pulsetto device, but I'd currently give the nod-of-the-hat to Pulsetto. However, they have been giving warnings that imply the device may not continue to be available in the US due to tariff wars, or, in the fine print, that the price may have the be increased. As mentioned above, the durable feel of the device and battery life were wins for Pulsetto. While some competitors label it a "shock collar," any vagus nerve stimulator will apply an electrical current that feels like a gentle pulse when dialed in correctly. Having said that, I've been taken by surprise by both units. When the Pulsetto is set too high, is stimulates my neck muscles causing mildly spastic movements, feeling like a muscle cramp. Likewise, I've had sessions with the Xen in which, despite utilizing the saline spray, I was not experiencing any conductivity / stimulation. This resulted in adjusting the intensity and repositioning the earbud, and ultimately some sharp zaps to my ear canal that were unpleasant. The Pulsetto feels more like a pulse while the Xen feels more like a tingle when set in the range I like.
While I love music, I have not really utilized the audio feature of the Xen, but I suspect most audiophiles wouldn't feel the sound quality compares to high end earbuds or cans.
From a mental health standpoint, as a psychologist, I have found it to be quite soothing and lasting, as if stress left my motor running at high RPM and these devices downregulate that in a short session length. It seems to last quite a while, possibly until reactivated by a stressful trigger or liquid-stress (coffee). However, there are several caveats.
These are newer devices and not medical, so they may not replace other treatments. As mentioned in the disclaimer, I cannot speak to their safety, but we shouldn't just assume safety of any medication or device that affects our body.
This is not a replacement for psychotherapy and psychotherapeutic coping skills. Deep breathing, muscle relaxation, guided imagery and grounding, and mindfulness meditations are equally effective (in my opinion) parasympathetic activation techniques, and there is something to be said about learning a skill to manage this on your own. What if you don't have your Vagus Nerve Stimulator or it runs out of batteries? I'm consistently surprised that my clients aren't very engaged in practicing and consistently utilizing these copings skills - I felt it was diligent to practice what I preach when learning these skills as a therapist-in-training, and they have helped me through rough patches. Check out my YouTube channel for Parasympathetic Activation.
Resistance to relaxation is well documented in psychological literature. Frequently we have ambivalence about changing the things that bring us into therapy - when that isn't the case, people are much more successful at solving their hurdles without the support of a therapist. See my article on uncertainty in psychotherapy. People with overbearing superego's or parental internalizations (including the IFS notion of a protector/manager) often unconsciously invite this part to take control, giving them a sense of control, but ultimately losing control to that part, pattern and rigid way of coping. Yet it is familiar, and creates a homeostasis or stable system of functioning. On the surface, they want to change this, but as we dig deeper, fears of letting go of that familiar coping and consequently sense of control are scary. It may feel reckless or sociopathic, and out of control. Over the course of therapy, these individuals learn to trust themselves without the internal critic, but this is a process. Medications and devices like a vagus nerve stimulator do this automatically and nearly immediately without the therapeutic process, which can cause resistance: the internal protective mechanism resists being forcefully shut of and rises up stronger. While I suspect this presentation is not the norm, it would need to be navigated. This is analogous to the phenomonen in which individuals with fragile egos related to narcissistic personality traits had adverse reactions to meditation. Classic meditation techniques involves stripping away layers of conscious experience until we reach a core, but people with a fragile sense of self are naturally terrified to acknowledging the things they cling to for identity are only effervescent thoughts we have about ourselves. This topic is discussed in Epstein's Psychotherapy without the Self. When meeting with a representative of Neuvana (co-founder?), we discussed this potential complication and that she had been surprised the notion was familiar in discussion with other psychologists as well. If you find yourself fearful of giving up a sense of self-control, consider consulting a therapist, and remember an overbearing internal critic only provides a sense of control - your core self or true ego is perfectly capable of providing this services and fulfilling this function. A brief moment of calm is good for you and does not mean you are reckless or out of control. Consider attempting other parasympathetic activation skills first (see link above for my YouTube videos) and attend to any resistance. If you notice resistance, open up an internal dialogue with that part of yourself and give it space to answer what it's fears are (of relaxing) and if it maybe wants a break from being in control all the time?
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