Vagus nerve stimulation for treatment-resistant mood disorders: a long-term naturalistic study

Abstract

BackgroundLimited therapeutic options are available for patients with treatment-refractory major depression who do not respond to routinely available therapies. Vagus nerve stimulation showed adjunctive antidepressant effect in chronic treatment resistant depression, even though available studies rarely exceed 2-year follow up.We report a naturalistic 5-year follow up of five patients who received VNS implant for resistant depression (3 patients with major depressive disorder and 2 with bipolar disorder).MethodsResponse was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.ResultsResponse and remission rates were both 40% (2/5) after 1 year, and 60% (3/5) at 5 years. Two patients withdrew from the study because of side effects or inefficacy of stimulation.ConclusionsOur case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.

Long-term Effects of Vagus Nerve Stimulation in Treatment-resistant Depression: A 5-year Follow up Case Series

“…In a recent naturalistic follow-up study conducted by Albert and colleagues on a sample of both unipolar and bipolar patients, similar results were observed [10]. To our knowledge, no further studies have investigated VNS properties over a follow-up period of 5 years.…”

High-Resolution Multi-Scale Computational Model for Non-Invasive Cervical Vagus Nerve Stimulation

“…For the treatment of epilepsy, VNS has been shown to reduce both seizure frequency and severity . In patients with MDD symptom severity is reduced, , though long‐term follow‐up is still ongoing .…”

Therapeutic implications of the choroid plexus–cerebrospinal fluid interface in neuropsychiatric disorders

“…In contrast to these results, some studies reported a reduction in function and amount of T cells during schizophrenia (Steiner et al, 2010;Craddock et al, 2007). Evidence for the role of a nervous component in neuropsychiatry was shown by the use of vagus nerve stimulation (VNS) for treatment-resistant mood disorders such as depression (Albert et al, 2015). VNS is an FDA approved treatment that improves depressive symptoms (Albert et al, 2015;Fang et al, 2015;Shiozawa et al, 2014).…”

“…Evidence for the role of a nervous component in neuropsychiatry was shown by the use of vagus nerve stimulation (VNS) for treatment-resistant mood disorders such as depression (Albert et al, 2015). VNS is an FDA approved treatment that improves depressive symptoms (Albert et al, 2015;Fang et al, 2015;Shiozawa et al, 2014). Hypofunction of the parasympathetic vagus nerve was also shown to be involved in the pathophysiology of schizophrenia (Bar et al, 2008(Bar et al, , 2005(Bar et al, , 2012Malaspina et al, 1997;Boettger et al, 2006;Ostermann et al, 2013).…”