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.Vagus nerve stimulation (VNS) has recently been approved for treating drug-resistant cases of clinical depression.[1] A convenient, non-invasive VNS device that stimulates an afferent branch of the vagus nerve is also being developed and will soon undergo trials.


In 2005, the FDA approved the use of VNS for treatment-resistant depression. [2]

Although the use of VNS for refractory depression has been endorsed by the American Psychiatric Association, the FDA's approval of VNS for refractory depression remains controversial. According to Dr. A. John Rush, vice chairman for research in the Department of Psychiatry at the University of Texas Southwestern Medical Center at Dallas, results of the VNS pilot study showed that 40 percent of the treated patients displayed at least a 50 percent or greater improvement in their condition, according to the Hamilton Depression Rating Scale. [3][4] Many other studies concur that VNS is indeed efficacious in treating depression. However, these finding do not take into account improvements over time in patients without the device. In the only randomized controlled trial VNS failed to perform any better when turned on than in otherwise similar implanted patients whose device was not turned on.[5] To better understand the opinions of the medical professionals relating to this treatment option a compilation has been prepared from the responses to CMS (Medicare) during the write-in period from 08/07/2006 - 09/06/2006 entitled "Letters from the Medical Professionals".

Patients

Charles E. Donovan, a study subject in the investigational trial of vagus nerve stimulation therapy for treatment-resistant depression, wrote Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression. [6]



See also

References & Bibliography

  1. Nemeroff C, Mayberg H, Krahl S, McNamara J, Frazer A, Henry T, George M, Charney D, Brannan S (2006). VNS therapy in treatment-resistant depression: clinical evidence and putative neurobiological mechanisms.. Neuropsychopharmacology 31 (7): 1345-55. PMID 16641939. link
  2. Groves, Duncan A., Brown, Verity J. (2005). Vagus Nerve Stimulation: A Review of its Applications and Potential Mechanisms That Mediate its Clinical Effects. Neuroscience and Biobehavioral Reviews, 29, 493-500.PMID 15820552
  3. Doctor's Guide: Vagus Nerve Stimulation Successful For Depression
  4. Neurology Channel: Vagus Nerve Stimulation
  5. FDA Summary of VNS Data
  6. Donovan, C. (2005.) Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression Wellness Publishers, LLC. Also: http://www.vagusnervestimulation.com/

Key texts

Books

Papers

  • Armitage, R., Husain, M., Hoffmann, R., & Rush, A. J. (2003). The effects of vagus nerve stimulation on sleep EEG in depression: A preliminary report. Journal of Psychosomatic Research, 54(5), 475-482.
  • Bajbouj, M., Gallinat, J., Lang, U. E., Hellen, F., Vesper, J., Lisanby, S. H., et al. (2007). Motor cortex excitability after vagus nerve stimulation in major depression. Journal of Clinical Psychopharmacology, 27(2), 156-159.
  • Bodenlos, J. S., Kose, S., Borckardt, J. J., Nahas, Z., Shaw, D., O'Neil, P. M., et al. (2007). Vagus nerve stimulation acutely alters food craving in adults with depression. Appetite, 48(2), 145-153.
  • Burke, M. J., & Husain, M. M. (2006). Concomitant Use of Vagus Nerve Stimulation and Electroconvulsive Therapy for Treatment-resistant Depression. Journal of ECT, 22(3), 218-222.
  • Conway, C. R., Sheline, Y. I., Chibnall, J. T., George, M. S., Fletcher, J. W., & Mintun, M. A. (2006). Cerebral blood flow changes during vagus nerve stimulation for depression. Psychiatry Research: Neuroimaging, 146(2), 179-184.
  • Corcoran, C. D., Thomas, P., Phillips, J., & O'Keane, V. (2006). Vagus nerve stimulation in chronic treatment-resistant depression: Preliminary findings of an open-label study. British Journal of Psychiatry, 189(3), 282-283.
  • Critchley, H. D., Lewis, P. A., Orth, M., Josephs, O., Deichmann, R., Trimble, M. R., et al. (2007). Vagus Nerve Stimulation for Treatment-Resistant Depression: Behavioral and Neural Effects on Encoding Negative Material. Psychosomatic Medicine, 69(1), 17-22.
  • Daban, C., Martinez-Aran, A., Cruz, N., & Vieta, E. (2008). Safety and efficacy of vagus nerve stimulation in treatment-resistant depression. A systematic review. Journal of Affective Disorders, 110(1-2), 1-15.
  • Das, U. N. (2007). Vagus nerve stimulation, depression, and inflammation. Neuropsychopharmacology, 32(9), 2053-2054.
  • George, M. S., Rush, A. J., Marangell, L. B., Sackeim, H. A., Brannan, S. K., Davis, S. M., et al. (2005). A One-Year Comparison of Vagus Nerve Stimulation with Treatment as Usual for Treatment-Resistant Depression. Biological Psychiatry, 58(5), 364-373.
  • George, M. S., Rush, A. J., Sackeim, H. A., & Marangell, L. B. (2003). Vagus nerve stimulation (VNS): Utility in neuropsychiatric disorders. International Journal of Neuropsychopharmacology, 6(1), 73-83.
  • George, M. S., Sackeim, H. A., Marangell, L. B., Husain, M. M., Nahas, Z., Lisanby, S. H., et al. (2000). Vagus nerve stimulation: A potential therapy for resistant depression? Psychiatric Clinics of North America, 23(4), 757-783.
  • George, M. S., Sackeim, H. A., Rush, A. J., Marangell, L. B., Nahas, Z., Husain, M. M., et al. (2000). Vagus nerve stimulation: A new tool for brain research and therapy. Biological Psychiatry, 47(4), 287-295.
  • Gorczyca, I., Zwolinski, P., Roszkowski, M., & Niemcewicz, S. (2006). Vagus nerve stimulation in severe, treatment-resistent depression. Psychiatria Polska, 40(6), 1137-1142.
  • Harden, C. L. (2001). Mood changes in epilepsy patients treated with vagus nerve stimulation. Epilepsy & Behavior, 2(3,Part2), S17-S20.
  • Harden, C. L., Pulver, M. C., Ravdin, L. D., Nikolov, B., Halper, J. P., & Labar, D. R. (2000). A pilot study of mood in epilepsy patients treated with vagus nerve stimulation. Epilepsy & Behavior, 1(2), 93-99.
  • Holtzheimer, P. E., III, & Avery, D. H. (2005). Focal Brain Stimulation For Treatment-Resistant Depression: Transcranial Magnetic Stimulation, Vagus-Nerve Stimulation, and Deep-Brain Stimulation. Primary Psychiatry, 12(2), 57-64.
  • Howland, R. H. (2006). Vagus Nerve Stimulation for Depression and Other Neuropsychiatric Disorders. Journal of Psychosocial Nursing & Mental Health Services, 44(9), 11-14.
  • Husain, M. M., Montgomery, J. H., Fernandes, P., & Morrow, L. (2002). Safety of vagus nerve stimulation with ECT. American Journal of Psychiatry, 159(7).
  • Husain, M. M., Stegman, D., & Trevino, K. (2005). Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: A case report. Annals of General Psychiatry, 4.
  • Kosel, M., & Schlaepfer, T. E. (2003). Beyond the treatment of epilepsy: New applications of vagus nerve stimulation in psychiatry. CNS Spectrums, 8(7), 515-521.
  • Krahl, S. E., Senanayake, S. S., Pekary, A. E., & Sattin, A. (2004). Vagus nerve stimulation (VNS) is effective in a rat model of antidepressant action. Journal of Psychiatric Research, 38(3), 237-240.
  • Labiner, D. M., & Ahern, G. L. (2007). Vagus nerve stimulation therapy in depression and epilepsy: Therapeutic parameter settings. Acta Neurologica Scandinavica, 115(1), 23-33.
  • Lang, U. E., Bajbouj, M., Gallinat, J., & Hellweg, R. (2006). Brain-derived neurotrophic factor serum concentrations in depressive patients during vagus nerve stimulation and repetitive transcranial magnetic stimulation. Psychopharmacology, 187(1), 56-59.
  • Lurie, P., & Stine, N. (2006). Responding to Three Articles Regarding Vagus Nerve Stimulation (VNS) for Depression. Biological Psychiatry, 60(12).
  • Marangell, L. B., Martinez, M., Martinez, J. M., George, M. S., & Sackeim, H. A. (2005). Vagus nerve stimulation: A new tool for treating depression. Primary Psychiatry, 12(10), 40-43.
  • Marangell, L. B., Rush, A. J., George, M. S., Sackeim, H. A., Johnson, C. R., Husain, M. M., et al. (2002). Vagus nerve stimulation (VNS) for major depressive episodes: One year outcomes. Biological Psychiatry, 51(4), 280-287.
  • Marangell, L. B., Rush, J. A., George, M. S., Georges, D., & Sackeim, H. A. (2001). A review of vagus nerve stimulation for treatment-resistant depression. Epilepsy & Behavior, 2(3,Part2), S6-S10.
  • Matthews, K., & Eljamel, M. S. (2003). Vagus nerve stimulation and refractory depression: Please can you switch me on doctor? British Journal of Psychiatry, 183(3), 181-183.
  • Merkl, A., Brakemeier, E. L., Danker-Hopfe, H., & Bajbouj, M. (2007). Vagus nerve stimulation improves restless legs syndrome associated with major depression: A case report. Journal of Clinical Psychiatry, 68(4), 635-636.
  • Milby, A. H., Halpern, C. H., & Baltuch, G. H. (2008). Vagus nerve stimulation for epilepsy and depression. Neurotherapeutics, 5(1), 75-85.
  • Nahas, Z., Marangell, L. B., Husain, M. M., Rush, A. J., Sackeim, H. A., Lisanby, S. H., et al. (2005). Two-Year Outcome of Vagus Nerve Stimulation (VNS) for Treatment of Major Depressive Episodes. Journal of Clinical Psychiatry, 66(9), 1097-1104.
  • Nahas, Z., Teneback, C., Chae, J.-H., Mu, Q., Molnar, C., Kozel, F. A., et al. (2007). Serial vagus nerve stimulation functional MRI in treatment-resistant depression. Neuropsychopharmacology, 32(8), 1649-1660.
  • Neuhaus, A. H., Luborzewski, A., Rentzsch, J., Brakemeier, E. L., Opgen-Rhein, C., Gallinat, J., et al. (2007). P300 is enhanced in responders to vagus nerve stimulation for treatment of major depressive disorder. Journal of Affective Disorders, 100(1-3), 123-128.
  • Nierenberg, A. A., Alpert, J. E., Gardner-Schuster, E. E., Seay, S., & Mischoulon, D. (2008). Vagus nerve stimulation: 2-year outcomes for bipolar versus unipolar treatment-resistant depression. Biological Psychiatry, 64(6), 455-460.
  • O'Reardon, J. P., Cristancho, P., & Peshek, A. D. (2006). Vagus Nerve Stimulation (VNS) and Treatment of Depression: To the Brainstem and Beyond. Psychiatry, 3(5), 54-62.
  • Padberg, F., Grossheinrich, N., Schonfeldt-Lecuona, C., & Pogarell, O. (2006). Update on vagus nerve stimulation and deep brain stimulation in depression. Nervenheilkunde: Zeitschrift fur interdisziplinaere Fortbildung, 25(8), 635-640.
  • Prater, J. F. (2001). Recurrent depression with vagus nerve stimulation. American Journal of Psychiatry, 158(5), 816-817.
  • Rado, J., & Janicak, P. G. (2007). Vagus nerve stimulation for severe depression. Journal of Psychosocial Nursing & Mental Health Services, 45(7), 43-51.
  • Rush, A. J., & George, M. S. (2006). "Responding to three articles regarding vagus nerve stimulation (VNS) for depression": Reply. Biological Psychiatry, 60(12), 1382-1383.
  • Rush, A. J., George, M. S., Sackeim, H. A., Marangell, L. B., Husain, M. M., Giller, C., et al. (2000). Vagus nerve stimulation (VNS) for treatment-resistant depressions: A multicenter study. Biological Psychiatry, 47(4), 276-286.
  • Rush, A. J., Marangell, L. B., Sackeim, H. A., George, M. S., Brannan, S. K., Davis, S. M., et al. (2005). Vagus Nerve Stimulation for Treatment-Resistant Depression: A Randomized, Controlled Acute Phase Trial. Biological Psychiatry, 58(5), 347-354.
  • Rush, A. J., Sackeim, H. A., Marangell, L. B., George, M. S., Brannan, S. K., Davis, S. M., et al. (2005). Effects of 12 Months of Vagus Nerve Stimulation in Treatment-Resistant Depression: A Naturalistic Study. Biological Psychiatry, 58(5), 355-363.
  • Sackeim, H. A., & Lisanby, S. H. (2001). Physical treatments in psychiatry: Advances in electroconvulsive therapy, transcranial magnetic stimulation, and vagus nerve stimulation. Treatment of depression: Bridging the 21st century., 151-174.
  • Sackeim, H. A., Rush, A. J., George, M. S., Marangell, L. B., Husain, M. M., Nahas, Z., et al. (2001). Vagus nerve stimulation (VNS-super(TM)) for treatment-resistant depression: Efficacy, side effects, and predictors of outcome. Neuropsychopharmacology, 25(5), 713-728.
  • Schachter, S. C. (2004). Vagus nerve stimulation: Mood and cognitive effects. Epilepsy & Behavior, 5(Suppl1), S56-S59.
  • Schlaepfer, T., & Kosel, M. (2004). Novel physical treatments for major depression: Vagus nerve stimulation, transcranial magnetic stimulation and magnetic seizure therapy. Current Opinion in Psychiatry, 17(1), 15-20.
  • Schlaepfer, T. E., Frick, C., Zobel, A., Maier, W., Heuser, I., Bajbouj, M., et al. (2008). Vagus nerve stimulation for depression: Efficacy and safety in a European study. Psychological Medicine, 38(5), 651-661.
  • Schwartz, T. L., & Costello, A. (2007). Charting a sustained response to vagus nerve stimulation in treatment-resistant major depressive disorder. Primary Psychiatry, 14(8), 66-68.
  • Sperling, W., Reulbach, U., Maihofner, C., Kornhuber, J., & Bleich, S. (2008). Vagus nerve stimulation in a patient with Gilles de la Tourette syndrome and major depression. Pharmacopsychiatry, 41(3), 117-118
  • Zobel, A., Joe, A., Freymann, N., Clusmann, H., Schramm, J., Reinhardt, M., et al. (2005). Changes in regional cerebral blood flow by therapeutic vagus nerve stimulation in depression: An exploratory approach. Psychiatry Research: Neuroimaging, 139(3), 165-179.

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