Hope for Resistant Depression
Most of the time, depression is an ailment that can be treated with ease, but some cases remain stubborn, with patients desperate for relief. Now, 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.
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 approves 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.
There can be harmful 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 VNS include:
Voice changes and hoarseness
Breathing difficulties, most often with exertion
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 acquainted with your condition.