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Why it's done
By Mayo Clinic staff
Antidepressant medications, psychological counseling (psychotherapy) or electroconvulsive therapy (ECT) can improve depression in most people. But everyone's different, and for some people these standard depression treatments don't work very well. In such cases, vagus nerve stimulation may be added to standard treatments to help relieve symptoms.
When vagus nerve stimulation may be a good option
The Food and Drug Administration (FDA) has approved vagus nerve stimulation for people who:
- Are adults (age 18 or older)
- Have chronic, hard-to-treat depression (treatment-resistant depression)
- Haven't improved after trying four or more medications or electroconvulsive therapy (ECT), or both
- Continue standard depression treatments along with vagus nerve stimulation
Vagus nerve stimulation doesn't always relieve depression
Vagus nerve stimulation has been used for treatment-resistant epilepsy for over a decade and is known to produce good results. The benefits for depression aren't so clear.
The possibility that vagus nerve stimulation might work to treat depression was identified when it was being studied in people with epilepsy. Researchers noticed that some people who were getting vagus nerve stimulation had an improved mood. This led to further studies, which have produced mixed results.
For most people, vagus nerve stimulation doesn't significantly ease depression symptoms. However, it does seem to make a significant difference for some people. However, results vary from person to person.
Some mental health experts don't recommend its use for depression at all, and most health insurance companies don't cover the procedure for depression treatment. This can be a concern, as the vagus nerve stimulation device and surgery to implant it is expensive.
- Dougherty DD, et al. Vagus nerve stimulation. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/205162974-3/0/1657/451.html?tocnode=57543416&fromURL=451.html#4-u1.0-B978-0-323-04743-2..50048-2--cesec4_1191. Accessed June 10, 2010.
- George MS, et al. Nompharmacological somatic treatments. In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/content.aspx?aID=332262. Accessed June 14, 2010.
- VNS Therapy system — P970003s050. U.S. Food and Drug Administration. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm078532.htm. Accessed June 14, 2010.
- Grimm S, et al. Efficacy of vagus nerve stimulation in the treatment of depression. Expert Reviews of Neurotherapeutics. 2010;10:87.
- Implantation procedure. Cybertronics. http://dynamic.cyberonics.com/manuals/doc_download.asp?docid={D6761ECC-D653-4175-84CB-E8C4AF92645D}. Accessed June 14, 2010.
- Schachter SS, et al. Vagus nerve stimulation therapy. http://www.uptodate.com/home/index.html. Accessed June 10, 2010.
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