Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study.
BACKGROUND
Vagus Nerve Stimulation (VNS) delivered by the NeuroCybernetic Prosthesis (NCP) System was examined for its potential antidepressant effects.


METHODS
Adult outpatients (n = 30) with nonpsychotic, treatment-resistant major depressive (n = 21) or bipolar I (n = 4) or II (n = 5; depressed phase) disorders who had failed at least two robust medication trials in the current major depressive episode (MDE) while on stable medication regimens completed a baseline period followed by NCP System implantation. A 2-week, single-blind recovery period (no stimulation) was followed by 10 weeks of VNS.


RESULTS
In the current MDE (median length = 4.7 years), patients had not adequately responded to two (n = 9), three (n = 2), four (n = 6), or five or more (n = 13) robust antidepressant medication trials or electroconvulsive therapy (n = 17). Baseline 28-item Hamilton Depression Rating Scale (HDRS(28)) scores averaged 38.0. Response rates (> or =50% reduction in baseline scores) were 40% for both the HDRS(28) and the Clinical Global Impressions-Improvement index (score of 1 or 2) and 50% for the Montgomery-Asberg Depression Rating Scale. Symptomatic responses (accompanied by substantial functional improvement) have been largely sustained during long-term follow-up to date.


CONCLUSIONS
These open trial results suggest that VNS has antidepressant effects in treatment-resistant depressions.
Rush
A J
AJ
Departments of Psychiatry and Neurosurgery, University of Texas Southwestern Medical Center, Dallas 75235-9086, USA.
George
M S
MS
Sackeim
H A
HA
Marangell
L B
LB
Husain
M M
MM
Giller
C
C
Nahas
Z
Z
Haines
S
S
Simpson
R K
RK
Goodman
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004565:Electroconvulsive Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012016:Reference Values; D016037:Single-Blind Method; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology*