Vagus Nerve Stimulation: A new Depression Treatment Option
By editor | June 10, 2007
This new procedure uses brain stimulation to improve symptoms, but long-term effects aren’t yet known. Discover how it works and understand the pros and cons
Depression is usually a very treatable condition. Often, standard treatment with antidepressant medications, psychotherapy or electroconvulsive therapy can help improve even severe cases of depression.
But if standard depression treatment doesn’t work, a relatively new type of treatment involving brain stimulation may be an option. In mid-2005, the Food and Drug Administration (FDA) approved a type of brain stimulation called vagus nerve stimulation for certain types of depression.
How vagus nerve stimulation works
The vagus nerve serves as a primary communication pathway between your brain and such major organs as your heart, lungs and intestines. There’s one vagus nerve on each side of your body. The nerve runs from your brainstem through your neck and down to your chest and abdomen. Information travels through this nerve to and from your central nervous system.
Vagus nerve stimulation uses electrical impulses to affect mood centers in the brain by stimulating the vagus nerve. The treatment is sometimes called vagal nerve stimulation.
With vagus nerve stimulation, a device called a pulse generator is surgically implanted in the upper left side of your chest. The device is about the size of a stopwatch. A lead wire is connected to the pulse generator. The lead wire is guided under your skin from your chest up to your neck, where it’s attached to the left vagus nerve.
Electrical signals travel from the pulse generator, through the lead wire and to the vagus nerve. The vagus nerve delivers those signals to the brain. But precisely how stimulation of the vagus nerve may improve depression remains unknown. Research indicates that vagus nerve stimulation alters the functioning of brain areas involved in mood regulation and depression.
.Who may benefit from vagus nerve stimulation?
Vagus nerve stimulation may not be appropriate for all cases of depression. In fact, the FDA approved use of vagus nerve stimulation in depression only for these specific situations:
For treatment of long-term, chronic depression that lasts two or more years, in conjunction with standard treatments
Recurrent or severe depression
Depression that hasn’t improved after the use of at least four other treatments, such as four different antidepressants
The approval of vagus nerve stimulation for depression didn’t come without controversy, though. In fact, some FDA scientists repeatedly recommended against its approval. Not all scientific studies have shown that vagus nerve stimulation is an effective treatment for depression. In fact, some studies have suggested it’s no more effective than a placebo. Additional research will help determine its long-term effectiveness and safety.
Common side effects and adverse health problems associated with vagus nerve stimulation include:
- Voice changes
- Hoarseness
- Cough
- Neck pain
- Breathing problems, especially during exercise
- Difficulty swallowing
- Tingling or prickling of the skin
- Sore throat
There’s also a small risk that the pulse generator may malfunction or move about within your body. You may then require additional surgery to fix or remove the device.
On the other hand, vagus nerve stimulation doesn’t have the side effects that are typical of antidepressants. For instance, it’s not associated with weight gain, sexual problems, memory problems, food or medication interactions, or sleep disturbances.
Tags: brain stimulation Depression Tips electroconvulsive therapy food and drug administration vagus nerve stimulation
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