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With Mayo Clinic psychiatrist Gabrielle J. Melin, M.D.

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August 15, 2008

Vagus nerve stimulation a treatment option, but not for everyone

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By Gabrielle J. Melin, M.D.

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Vagus nerve stimulation was approved by the Food and Drug Administration (FDA) in the summer of 2005 for the treatment of chronic, or recurrent, treatment-resistant depression (not as a first-line treatment). More specifically, it is indicated for those whose depression has not responded to the usual treatments. As with deep brain stimulation this is not a treatment that is for everyone. Vagus nerve stimulation also did not effectively treat depression in everyone who does receive it. Vagus nerve stimulation was first approved by the FDA in 1997 for use in epilepsy (seizure disorder).

Vagus nerve stimulation requires that an electrode or pulse generator (like a pacemaker) is surgically implanted under the skin in the left area of the chest. A wire is connected from the electrode to the left vagus nerve. The vagus nerve is connected to the brain and sends signals to the brain. This leads to stimulation of the limbic system in the brain. This system is responsible for regulating a variety of functions — including mood, appetite, motivation and sleep patterns. We know that all of these can be affected during a depressive episode.

Vagus nerve stimulation may take several months before appreciable benefit is noticed. Medications, too, can take 6 to 8 or more weeks to get the full benefit. Vagus nerve stimulation though, does not tend to have side effects that are possible with some medications, such as weight gain and sexual dysfunction. Vagus nerve stimulation is used in combination with other therapies including medications and electroconvulsive therapy (ECT).

Mayo Clinic does not treat depression with vagus nerve stimulation. We would recommend you check with a major university or teaching /tertiary hospital in your state for additional information. If you qualify for vagus nerve stimulation, check with your insurance company as well to see if it is covered.

As always, thank you sincerely for your interest in mayoclinic.com.

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7 comments posted

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November 13, 2008 9:07 a.m.

Good Morning bloggers - We cannot vouch that the Web site mentioned below (VNS message board) contains accurate or helpful information. The site has not been research or approved by Mayo. Please be cautious when seeking information on the Internet. We appreciate all of you writing in to help others. We generally will remove site names as we cannot guarantee that the information is accurate. We also do not have the resources to research sites provided by readers. Thank you for understanding. Please seek information from your health care provider; ask your provider if they're aware of support groups or patients that are willing to provide testimonials.

- MC.com Staff

November 12, 2008 8:18 p.m.

There is a wealth of information at vnsmessageboard.com This site provides information by patients who have been implanted with VNS for depression and epilepsy. There is straight talk about the positive and negative aspects of VNS.

- Oreo

October 14, 2008 6:20 p.m.

What a great idea. The public should know more of this and be able to include this therapy, along with their doctor, in there best choices for overall therapy for that individual.

- S. Martin

August 21, 2008 10:13 a.m.

can someone elaborate on vagus nerve stimulation for psychosomtic disorders like constipation

- No name given

August 20, 2008 10:39 a.m.

My vagus nerve is damaged during surgery for reflux disease. I cannot digest liquids without solids.

- Rose Kassardjian

August 15, 2008 6:35 p.m.

I have the VNS for my seizure disorder. I don't think the magnets for extra "bursts" of electricity are used when it's implanted for people with depression? Does anyone know for sure?

- NativeRose

August 15, 2008 3:19 p.m.

I've had the vagus nerve stimulator since 2001 when it was still in clinical trials. I've suffered from treatment resistant depression since my teens (I'm now 42). I am now considered "in remission" and take only one medication for depression (and the same one for four years). While I understand the results are not the same for everyone and this is not a CURE ALL, it has helped me enormously. I've never had such stability and been so content. I still have periods where there's struggle but not nearly the lows or duration of those lows (not even close). Living with depression requires having a toolbox of coping mechanisms and knowing that you have to reach down and use yours strengths to fight is, the battle it not nearly at difficult now.

- Robin