Vagus Nerve Stimulation for treating Depression

A potential therapy for resistant depression?

Vagus nerve stimulation, an effective epilepsy treatment, has produced encouraging preliminary results for patients suffering from " treatment-resistant depression," and a study beginning at University Medical Center (Univ. of Arizona) and a handful of other U.S. sites may verify the promising new therapy. Approximately 18 million Americans suffer from depression, about 1 million of whom have severe treatment-resistant depression.

FDA approval for the Vagal Nerve Stimulator (VNS) came July 1997 as adjunctive treatment of complex partial seizures for patients over 12 years old. As with any approved treatment, "off label" use is permitted and epileptologists have already implanted children younger than 12 (three y.o.), and treated patient with other than complex partial seizures(absences, Lennox-Gastuat).

Vagus Nerve Stimulation VNS therapy consists of intermittent stimulation (typically 30 seconds on, five minutes off) of the left cervical vagus nerve delivered via the VNS Therapy System. The principal components of the VNS Therapy System are an implantable pulse generator and lead, and an external programming system. In the United States, the VNS Therapy System is approved as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over 12 years of age with partial onset seizures which are refractory to antiepileptic medications. This application provides evidence to support the safety and effectiveness of VNS therapy for an additional indication as an adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode that has not had an adequate response to two or more adequate antidepressant treatments.

The procedure usually lasts about 50 to 90 minutes with the patient under general anesthesia. Sometimes a hospital stay of one night is required. Some surgeons have performed the procedure with local anesthesia and the patient has been discharged the same day

The study patients are implanted with a NeuroCybernetic Prosthesis (NCP) System, which consists of a battery-powered generator implanted in the chest and a lead attached, at neck level, to the vagus nerve leading to the brain. The device delivers an automatic, periodic electrical stimulation to the vegus nerve. A physician can adjust the intensity, duration and frequency of the stimulation, which may be minimally noticeable by the patient, in follow-up visits.

The Vagus Nerve Stimulation device costs $12,000 and the cost of surgery to implant the device can run as high as $15,000.

The possible side-effects that have been reported at some time during treatment that were significantly increased, were

• voice alteration/hoarseness,
• cough,
• throat pain,
• nonspecific pain,
• dyspnoea,
• paraesthesia,
• dyspepsia,
• vomiting and
• infection.

No cognitive, sedative, visual, affective, or coordination side effects have been reported.

How do I find out how to have this done and how to get it paid for?  My son, who is 31, has suffered from treatment resistant depression since his teen years.  He has been on over 30 medications, and has had a series of ECT treatments with little effect.  Please help.
Thanks. -- (Joanne Donaldson)

I wish that private insurers would step up to the plate and fun VNS surgery for treatment resistant depression. --Christian

I have treatment resistant depression also, and this is the first time that I've heard I am not alone in 36 years. Every time they come out with a new drug; I just get my hopes built up for another let down. It's so hard and lonely living like this! Everyone wants to live as long as possible and all I can do is ask WHY? God Bless us All! - Val

I had a VNS implant put in a month and a half ago. I have already notice improvement in my depression. My husband has commented on it also. I am glad that my doctor suggested this treatment and that my insurance approved the procedure. It is not cheap, but it is the best decision I have made for my long term care with this illness. -- Heather Johnson

I would like to try this - i have treatment resistant depression. I have been in therapy for over four years and on at least 5 anti-depressants. Also, when a person has this device, is it highly visible? - SadGirl1