Deep Brain Stimulation
Still in Clinical Trial
One of the more treatable mental illnesses, depression, can be treated with medication, psychotherapy, and electroconvulsive therapy and these can be very effective; but when depression remains unresponsive, you may wish to consider an alternative or experimental treatment. Your physician may be able to help you enter a clinical trial for a treatment such as deep brain stimulation that needs further testing before receiving approval by the Food and Drug Administration.
Two Surgical Procedures
Deep brain stimulation is still experimental as a treatment of depression but has become standard treatment for those with Parkinson's disease. Treatment involves two surgeries--one to implant electrodes in your brain, and one to implant a neurostimulator in your chest. During the brain surgery, you receive local anesthetics to numb the area but remain awake so the surgeon can converse with you, helping him determine that the correct areas of your brain are being stimulated. Your head is placed in a special frame to immobilize it during surgery. Two holes are drilled in your skull and electrodes are implanted on either side of the brain.
In the second portion of the surgery, wires from the electrodes implanted in your brain are guided through the skin down to a battery-operated neurostimulator placed in your chest. The brain is stimulated as electric signals travel through the wires to the electrodes. Programming the neurostimulator is done with ease and is noninvasive. In general, stimulation is a continuous procedure occurring 24 hours a day.
Some researchers believe that areas in the brain associated with depression may be overactive in certain people and that sending electrical impulses to these areas may help reset their status to that of normal function. Clinical trials are not far along on treating depression with this method and it is not yet known if effects are long term. Because of the risks associated with deep brain stimulation, its use is limited to treating people with severe depression that is unresponsive to standard treatment.
Common side effects or health problems associated with deep brain stimulation include:
Undesirable changes in mood
Less common side effects include panic attack, speech difficulties, mobility issues, and suicide. Hardware can malfunction and batteries need replacing every one to three years. There is no question that treatment with deep brain stimulation is both serious and risky and should be considered only when depression incapacitates or is a life-threatening condition.