Hope for Resistant Depression

Most of the time, major depression is an ailment that can be treated with a number of effective techniques, but some cases remain stubborn, with patients desperate for relief. A new type of treatment involving brain stimulation may be an effective option. The Food and Drug Administration (FDA) approved vagus nerve stimulation for certain types of depression in 2005.

Information Highway

The two vagus nerves on either side of your body run from the brainstem through the neck, on down to your chest and abdomen, acting as a line of communication to and from the central nervous system. In vagus nerve stimulation (VNS), electrical impulses are used to affect mood centers in your brain through means of a small device called a pulse generator, implanted in the upper left side of the chest. A lead wire runs from the device to the left vagus nerve which then delivers those signals to areas of your brain that regulate mood and are responsible for depression. The device, a permanent implant, runs on battery power.

The FDA approved VNS for the following cases:

  • Chronic depression lasting two or more years in conjunction with standard treatments
  • Severe or recurrent depression
  • Depression that shows no sign of improvement after at least four other therapies, such as four different antidepressants.

Side Effects

There can be unwanted side effects to vagus nerve stimulation such as complications from implantation surgery. There may also be unwanted side effects that can be minimized by adjusting the frequency and current of the electrical impulses.

Common side effects of vagus nerve stimulation include:

  • Voice changes and hoarseness
  • Cough
  • Neck pain
  • Breathing difficulties, most often with exertion
  • Swallowing problems
  • Prickling sensation
  • Sore Throat

There is a slight risk of pulse generator malfunction or migration in the body. Additional surgery may be needed to correct such a situation. The device can be deactivated for a short length of time which may be useful during heavy exercise. This is done by holding a magnet over the chest in the area of the implant.

Real or Placebo?

Side effects notwithstanding, VNS, unlike antidepressants doesn’t cause weight gain, sexual or memory problems, interactions with food or medications, or sleep disturbances. Researchers hope that VNS may be an alternative treatment for electroconvulsive therapy (ECT) without the risks, though some studies liken the effect of VNS to a placebo. As with any new therapy, make a list of pros and cons and discuss this option with a mental health professional well acquainted with your condition.

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