VNS: Depression: New Treatment

October 7, 2005
UCSD Team Offers New Surgical Treatment For Severe Depression
By Debra Kain

Major depressive disorder is a very common illness, affecting nearly 18 million Americans and 340 million people worldwide. Treatment-resistant depression is a severe form of the illness that affects 20% of patients with depression.

A team of psychiatrists and neurosurgeons at the University of California, San Diego (UCSD) Medical Center is the first in the area to offer implantation of a device recently approved by the Food and Drug Administration (FDA) for treating patients with treatment-resistant depression.

Called Vagus Nerve Stimulation (VNS), the therapy is delivered from a pacemaker-like generator implanted in the chest that sends mild and intermittent electrical pulses through the vagus nerve in the neck to the brain.

The vagus nerve, one of the 12 cranial nerves, serves as the body’s “information highway” connecting the brain to many major organs. Several studies have shown that VNS therapy may modulate neurotransmitters such as serotonin and norepinephrine thought to be involved in mood regulation.

The VNS device itself is very small – perhaps 2 inches in diameter – and, at one ounce, is about the size of a wafer cookie. It is attached to two very thin leads, which are threaded under the skin and connected to the vagus nerve in an hour-long outpatient surgical procedure.

The treatment was approved by the FDA in July of this year as “an adjunctive long-term treatment for chronic or recurrent depression in patients 18 years of age and older who are experiencing a major depressive episode that has not responded adequately to four or more antidepressant treatments.”