Two-year outcome of vagus nerve stimulation in treatment-resistant depression.
One of the major goals of antidepressant treatment is a sustained response and remission of depressive symptoms. Some of the previous studies of vagus nerve stimulation (VNS) have suggested antidepressant effects. Our naturalistic study assessed the efficacy and the safety of VNS in 74 European patients with therapy-resistant major depressive disorder. Psychometric measures were obtained after 3, 12, and 24 months of VNS. Mixed-model repeated-measures analysis of variance revealed a significant reduction (P < or = 0.05) at all the 3 time points in the 28-item Hamilton Rating Scale for Depression (HRSD28) score, the primary outcome measure. After 2 years, 53.1% (26/49) of the patients fulfilled the response criteria (> or =50% reduction in the HRSD28 scores from baseline) and 38.9% (19/49) fulfilled the remission criteria (HRSD28 scores < or = 10). The proportion of patients who fulfilled the remission criteria remained constant as the duration of VNS treatment increased. Voice alteration, cough, and pain were the most frequently reported adverse effects. Two patients committed suicide during the study; no other deaths were reported. No statistically significant differences were seen in the number of concomitant antidepressant medications. The results of this 2-year open-label trial suggest a clinical response and a comparatively benign adverse effect profile among patients with treatment-resistant depression.
Bajbouj
Malek
M
Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. malek.bajbouj@charite.de
Merkl
Angela
A
Schlaepfer
Thomas E
TE
Frick
Caroline
C
Zobel
Astrid
A
Maier
Wolfgang
W
O'Keane
Veronica
V
Corcoran
Ciaran
C
Adolfsson
Rolf
R
Trimble
Michael
M
Rau
Harald
H
Hoff
Hans-Joachim
HJ
Padberg
Frank
F
Müller-Siecheneder
Florian
F
Audenaert
Kurt
K
van den Abbeele
Dirk
D
Matthews
Keith
K
Christmas
David
D
Eljamel
Sam
S
Heuser
Isabella
I
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*; D055815:Young Adult