Medical Electrical stimulation of the Vagus nerve may relieve treatment-resistant depression

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Vagus nerve stimulation (VNS) is emerging as a promising alternative treatment for patients with chronic or recurrent depression who have not responded to traditional medications. Approved by the FDA in 2005, VNS involves implanting a small pulse generator that stimulates the vagus nerve, which connects the brain to various organs. This stimulation sends regular pulses to brain areas involved in mood regulation, potentially improving symptoms of depression. Recent discussions highlight that VNS has received Medicare and Medicaid coverage, making it more accessible. While patients like Nick report significant improvements in their quality of life, it is emphasized that VNS is not a standalone solution; behavioral modifications and coping techniques are also essential for effective treatment. The conversation also touches on the broader applications of vagal stimulation in treating other conditions, noting that while VNS can have side effects, it offers a new avenue for those resistant to conventional therapies.
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This is an interesting new alternative to medication-based treatment of depression. So far it is only a candidate for patients who do not improve with medications, and recently it has been approved for Medicare/Medicaid coverage.

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Nearly 20 years ago, knowing all other options had failed, Nick’s sister, a nurse, recommended he check out a new treatment called vagus nerve stimulation, or VNS. The US Food and Drug Administration had just approved VNS in 2005 for the long-term adjunctive treatment of chronic or recurrent depression in adults who had had inadequate responses to at least four antidepressant treatments.

The vagus nerve “has over 100,000 individual nerves in a bundle,” said neuroscientist Dr. Bashar Badran, associate professor of psychiatry and director of the Neuro-X Lab at the Medical University of South Carolina in Charleston. “This bundle projects from your brain to every organ in your body, like your heart, your lungs, your spleen, your kidneys, your intestines.

“The vagus nerve is this bidirectional superhighway that relays information from your brain to your body.”

Nick soon enrolled as a participant in a VNS trial led by Dr. Charles Conway and had a VNS device implanted.

“It’s a very small pulse generator that’s similar to a cardiac pacemaker,” said Conway, professor of psychiatry and director of the Center for the Advancement of Research in Resistant Mood and Affective Disorders at Washington University in St. Louis.

The device is implanted underneath the collarbone, and a lead from the device is tunneled to the neck region, where it attaches to and stimulates the vagus nerve that, in turn, sends regular pulses to areas of the brain associated with mood regulation. The standard firing rate is 30 seconds every five minutes.

Nick remains on VNS treatment to this day in addition to being on two antidepressants he alternates using with his doctor’s instructions, depending on which one s working for him. “It completely changed my life. I find joy every single day,” he said.

“If it was just only medication, I don’t know that he would be alive today,” Mary said. “I tell Dr. Conway all the time, this was a miracle for us. Not to say that you don’t also have to do some behavior modifications, and you have to learn coping techniques and all that. It isn’t this magic bullet. It’s work, (but) it has saved our lives together, and his life.”

https://www.cnn.com/2024/12/19/heal...tion-depression-treatment-wellness/index.html
 
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Interesting, I had not seen this application before, thanks for the post!

But the other direction; vagal stimulation in various cardiovasvular problems and many other conditions in medication-resistance cases are well known. https://pmc.ncbi.nlm.nih.gov/articles/PMC6996447/

But it's interesting to see it applied in the other direction!

Medication always come with a range of side effects, but I presume a blunt stimulation of the vagus nerve can also cause multiple effects as well, not just on the brain.

/Fredrik
 
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