Vagus Nerve Stimulation: Changing the Paradigm for Chronic Severe Depression? Author: Aaronson ST1, Conway CR2 Affiliation: <sup>1</sup>Clinical Research Programs, Sheppard Pratt Health System, 6501 North Charles Street, Towson, MD 21204, USA; Department of Psychiatry, University of Maryland Medical School, 655 West Baltimore Street, Baltimore, MD 21201, USA. Electronic address: saaronson@sheppardpratt.org. <sup>2</sup>Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St Louis, MO 63110, USA. Conference/Journal: Psychiatr Clin North Am. Date published: 2018 Sep Other: Volume ID: 41 , Issue ID: 3 , Pages: 409-418 , Special Notes: doi: 10.1016/j.psc.2018.05.001. , Word Count: 113 Vagus nerve stimulation (VNS) has been studied for its effect on treatment-resistant depression. Open-label studies have shown a significant positive effect in an especially treatment-resistant depressive population. Insurance company support for VNS has been limited but may be reviewed given recent positive open-label data. Coming developments in novel external ways to stimulate the vagus nerve may revive interest in this area. This article reviews the clinical development of VNS starting with the first recognition of its potential for treating depression, parses the results of several large clinical trials, and suggests a future path for optimal clinical development and use. KEYWORDS: Major depression; Neurostimulation; Treatment-resistant major depression; Vagus nerve stimulation PMID: 30098654 DOI: 10.1016/j.psc.2018.05.001