Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study

Author: A J Rush1, M S George, H A Sackeim, L B Marangell, M M Husain, C Giller, Z Nahas, S Haines, R K Simpson Jr, R Goodman
1 Departments of Psychiatry and Neurosurgery, University of Texas Southwestern Medical Center, Dallas 75235-9086, USA.
Conference/Journal: Biol Psychiatry
Date published: 2000 Feb 15
Other: Volume ID: 47 , Issue ID: 4 , Pages: 276-86 , Special Notes: doi: 10.1016/s0006-3223(99)00304-2. , Word Count: 188

Vagus Nerve Stimulation (VNS) delivered by the NeuroCybernetic Prosthesis (NCP) System was examined for its potential antidepressant effects.

Adult outpatients (n = 30) with nonpsychotic, treatment-resistant major depressive (n = 21) or bipolar I (n = 4) or II (n = 5; depressed phase) disorders who had failed at least two robust medication trials in the current major depressive episode (MDE) while on stable medication regimens completed a baseline period followed by NCP System implantation. A 2-week, single-blind recovery period (no stimulation) was followed by 10 weeks of VNS.

In the current MDE (median length = 4.7 years), patients had not adequately responded to two (n = 9), three (n = 2), four (n = 6), or five or more (n = 13) robust antidepressant medication trials or electroconvulsive therapy (n = 17). Baseline 28-item Hamilton Depression Rating Scale (HDRS(28)) scores averaged 38.0. Response rates (> or =50% reduction in baseline scores) were 40% for both the HDRS(28) and the Clinical Global Impressions-Improvement index (score of 1 or 2) and 50% for the Montgomery-Asberg Depression Rating Scale. Symptomatic responses (accompanied by substantial functional improvement) have been largely sustained during long-term follow-up to date.

These open trial results suggest that VNS has antidepressant effects in treatment-resistant depressions.

PMID: 10686262 DOI: 10.1016/s0006-3223(99)00304-2