Authors' objectives: This report aims to summarise the available evidence on vagus nerve stimulation in the treatment of severe depression.

Authors' recommendations: Vagus nerve stimulation (VNS) has shown promising results in patients suffering from severe treatment-resistant depression. The results were obtained from a 30 patient, three month pilot study at four centres in the USA. Each patient was experiencing a Major Depressive Episode that had lasted longer than two years or had had at least four such episodes. The depressive symptoms were resistant to medication and 57% of patients were non-responsive to electro-convulsive therapy or were unable to tolerate it. The VNS pacemaker was implanted in the upper chest, with an electrode attached to the vagus nerve, and intermittent stimulation provided at the maximum dose that could be comfortably tolerated. Twelve patients (40%) showed a 50% or more improvement in their depression according to the Hamilton Rating Scale and 15 (50%) greater than 50% improvement as measured by the Montgomery Asberg Depression Rating Scale. The investigators comment that this response rate far exceeds that expected for patients with severe treatment-resistant depression. Those patients who responded maintained their response for months after the initial treatment period. Five responders had been treated for at least six months; five patients left the three month study without significant depressive symptoms. The FDA has granted Expedited Review status to VNS in this application and has approved an RCT, which is expected to start in mid-2000 and continue for about two years. Side effects of VNS include hoarseness, coughing, throat pain and shortness of breath, all of which occur during stimulation.

Authors' methods: Overview

Project Status: Completed

Year Published: 2000

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: Alberta Heritage Foundation for Medical Research (AHFMR)