Resistant Depression Looks to the Vagus Nerve Stimulator
Posted Jan 07 2009 6:52pm
Many people who experience depression have found tremendous relief of symptoms from talk therapy and antidepressant medications. But, there are many people whose depression does not improve with these treatments. These individuals have what is known in the clinical field as "treatment resistant depression". Up until now, those individuals with chronic depression were offered intensive treatments like Electro-Convulsive Therapy as a last resort.
Technology continues to be one the great cornerstones in treating psychological and psychiatric disorders. On July 15, 2005, the FDA approved Vagus Nerve Stimulation as a treatment for chronic depression.
The Vagus Nerve Stimulator (VNS) is not related to brain surgery, although it is a treatment that affects the function of the brain. VNS uses specific stimulation of the vagus nerve to send stimulation to specific parts of the brain that are involved in mood. It is not like Electro-Convulsive Therapy (ECT), a treatment that involves stimulation of the entire brain, results in short term memory loss and sometimes pain. Patients who have used VNS do not feel the stimulation from the stimulator since the vagus nerve does not have the type of nerves that carry pain signals. Nor does VNS interfere with memory loss. Patients having Vagus Nerve Stimulation can continue taking their other medications without worrying about side effects or interactions as well.
The Vagus Nerve Stimulator is a small device implanted under the skin near the collarbone. A wire under the skin connects the device to the vagus nerve in the neck. A physician programs the device to produce weak electrical signals that travel along the vagus nerve to the brain at regular intervals. These intervals ease the symptoms of depression. Five months after it was approved for sale, The VNS treatment for chronic, unresponsive or "resistant depression" is winning favor in the medical and psychological community.
Houston-based Cyberonics says a growing number of psychiatrists and surgeons are being trained to use its Vagus Nerve Stimulator, and an increasing number of insurance companies are agreeing to reimburse patients for their costs. In order to be a candidate for this new treatment, you must be a severely depressed adult who had not responded to at least four different treatment regimens.
As of December 2005, 62 insurance providers had agreed to pay for costs associated with VNS therapy. And many other insurance companies have agreed to reimburse patients who use the device on a case-by-case basis.
For those who have endured depression for many years without relief from traditional interventions, this new technology can offer life changing results. And it furthers our understanding that depression is a real, biological issue!
Anderson, B. et al. (2005). Vagus nerve stimulation affects pain perception in depressed adults. Pain Research & Management. 10(1), 9-14.
George, M.S. et al. (2005). A One-Year Comparison of Vagus Nerve Stimulation with Treatment as Usual for Treatment-Resistant Depression. Biological Psychiatry. 58(5), 364-373.