Vagus Nerve Stimulation for Chronic or Therapy-Resistant Depression

About Vagus Nerve Stimulation(VNS)

VNS is not brain surgical treatment, even though it is a therapy that affects the function of the brain. Vagus Nerve Stimulation utilizes specific stimulation of the vagus nerve to send stimulation to specific parts of the brain that are involved in mood. It is not like Electro-Convulsive Treatment (ECT), a therapy that involves stimulation of the whole brain and induces convulsions in patients. In reality, patients may not even feel the stimulation from VNS because the vagus nerve does not have the kind of nerves that have pain signals. Nor does VNS interfere with drugs, and patients getting Vagus Nerve Stimulation can continue taking their other drugs with out worrying about aspect results or interactions between drugs.

What is the Vagus Nerve ?

Vagus means “wandering” in Latin, and is the ideal description for the vagus nerve, the longest nerve in the physique. It averages almost two feet in duration and “wanders” all through the upper physique. The vagus nerve starts in the brain, goes down the neck and into the physique exactly where if affects the vocal cords, the acid content material of the abdomen, the heart, the lungs, and other organs. In the brain it tasks to areas thought to be responsible for seizures, mood, appetite, memory and anxiety (notice three). Nevertheless, the vagus nerve cord does not have numerous pain nerves, so stimulation of the vagus nerve is not agonizing, even though some patients may feel some sensation when electrical pulses are produced.

The Background of Vagus Nerve Stimulation

Vagus Nerve Stimulation has been used to deal with epilepsy patients for years the initial human medical trial was in 1988,(notice 1) and the FDA approved VNS therapy for epilepsy in 1997 (notice two). So much more than 22,000 individuals globally have had VNS therapy (notice three), and it has proven to be a safe and effective therapy for epilepsy. These patients have reported minimal aspect results, which have tended to decrease more than time. The efficacy of the therapy has also been shown to increase with longer therapy time (notice 1).

When Vagus Nerve Stimulation was initial approved for epilepsy, some patients reported an improvement in mood. Researchers made the decision to design a study specifically to measure modifications in a patient’s mood and depression because of to stimulation of the vagus nerve. In 1999, researchers began the initial open label (no placebo group) study for depression with sixty patients. This initial study discovered that there was indeed an improvement in mood for depressed patients. Primarily based on this study, a more detailed and thorough study was created to determine if Vagus Nerve Stimulation would be a safe, tolerable and effective therapy for chronic depression.

The lately finished 1-year, double blind, placebo controlled trial had 235 patients from 21 taking part hospitals in the United States, and showed clinically substantial enhancements because of to therapy in contrast to baseline (notice two). The acute (short-term) phase lasted 3 months, during which half of the patients obtained stimulation (therapy group) and half did not (manage group). The long-term phase of the study lasted an extra nine months (for 1 year complete therapy) of stimulation. The HRSD-24 (24 merchandise clinician-rated Hamilton Rating Scale for Depression) enhancements observed more than the initial year had been highly substantial. The outcomes of this long-term, pivotal study had been submitted to FDA in October 2003 the FDA’s decision on the use of Vagus Nerve Stimulation for depression is not anticipated before October 2004 (notice two). Of notice, Vagus Nerve Stimulation therapy was approved for use in patients with therapy resistant depression in the European Union in March 2001, and in Canada in April 2001 (notice two) .

How Does Vagus Nerve Stimulation Treatment function ?

The Pulse Generator (battery) delivers a little amount of electrical present to the vagus nerve intermittently (30 seconds on and 5 minutes off ) (notice three) 24 hours a day, 7 days a week for up to 10 years. The stimulation is delivered automatically, so the individual does not have to do something. Simply because there is nothing to remember, compliance is assured. The stimulation is not supposed to be unpleasant, and some patients do not even feel the stimulation. A nurse at the doctor’s office can adjust the level of stimulation (amount of electricity delivered) if the individual ever before feels unpleasant. In the study presently being reviewed by the FDA, researchers noted a number of similarities between epileptic and depressed patients (notice four).

One of the most essential similarities is that Vagus Nerve Stimulation therapy efficacy improves more than time. The longer the individual gets stimulation, the much better the outcomes. In addition, each populations of patients share the following:

Assured adherence to therapy regimen
Safety of the procedure
Safety of the therapy
Higher continuation rates
No drug interactions

What is the surgical treatment like?

Vagus Nerve Stimulation is NOT brain surgical treatment, even though it is an invasive surgical procedure that modifications the function of the brain. The stimulator is a pacemaker-like device that generates electrical pulses (Pulse Generator) it is implanted under the skin in the left chest via a little incision. While this may sound like a severe or harmful procedure, it is not. The FDA has approved the use, and confirmed the safety of this procedure, and 22,000 patients have obtained the implant to deal with epilepsy. The Vagus Nerve Stimulation surgical treatment involves two little incisions, 1 in the chest and 1 at the lowest component of the neck. At no time is the brain physically manipulated by the surgeon.

The surgical treatment to implant the NCP Program requires 45 minutes to two hours. Local, regional or common anesthesia (placing the individual to rest) is used during the surgical treatment the doctor and anesthetist determine which kind of anesthesia is best for every individual. Most Vagus Nerve Stimulation patients will have outpatient surgical treatment, (notice three) but some patients may need to remain in the hospital overnight, and in that situation they will need a family members member or companion to take them home from the hospital.

Learn more about this remarkable device at www.VagusNerveStimulator.com

Charles E. Donovan

Writer

Out of the Black Hole: The Patient’s Guide to Vagus Nerve Stimulation and Depression

http://www.VagusNerveStimulator.com