Vagus Nerve Stimulation Improved Treatment-Resistant Depression

MedicalResearch.com Interview with:

Scott T. Aaronson, M.D Psychiatrist, The Retreat at Sheppard Pratt Director of Clinical Research Sheppard Pratt Health System Baltimore, MD

Dr. Aaronson

Scott T. Aaronson, M.D
Psychiatrist, The Retreat at Sheppard Pratt
Director of Clinical Research
Sheppard Pratt Health System
Baltimore, MD

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is the largest ever conducted on patients with severe, chronic depression, a group typically ignored by clinical research in psychiatry. We looked at individuals who, on average, had received 8 unsuccessful treatment interventions in the past. These individuals were split into two groups and examined over five years. One group was given proven anti-depressant treatments (medications, psychotherapy, and/or electroconvulsive therapy (ECT)), and one group was given both anti-depressant treatments and VNS Therapy—an implantable, pacemaker-like device that stimulates the vagus nerve, which regulates mood in the brain.
• The study found that 67.9% of the VNS therapy group responded to treatment, compared to 40.9% of patients receiving treatment as usual. Importantly, the VNS therapy group reported responses earlier in treatment, and responses were sustained longer than those receiving treatment as usual.
• VNS therapy improved treatment effect in individuals whether they had unipolar or bipolar disorder, and whether or not they had responded to ECT in the past.

MedicalResearch.com: What should readers take away from your report?

Response: For patients with treatment-resistant depression, VNS therapy could prove to be a life-changing treatment option. For those who have responded to ECT in the past, VNS therapy could prove to be a less disruptive treatment option, since it doesn’t produce negative side effects of ECT such as headaches and confusion. For patients who haven’t responded to ECT or other proven anti-depressant treatments in the past, VNS therapy is a promising new treatment option that could provide relief from debilitating symptoms.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our results on VNS therapy are promising, and I hope further research will explore it’s efficacy further. It is also my hope that findings from this study will lead to increased available of VNS therapy for individuals with treatment-resistant depression.

Disclosures: The study was fully funded by the manufacturer of the VNS device, Cyberonics, now a division of LivaNova PLC.

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Citation:

A 5-Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality
Scott T. Aaronson, M.D., Peter Sears, C.C.R.P., Francis Ruvuna, Ph.D., Mark Bunker, Pharm.D., Charles R. Conway, M.D., Darin D. Dougherty, M.D., Frederick W. Reimherr, M.D., Thomas L. Schwartz, M.D., John M. Zajecka, M.D.
Published online: March 31, 2017 | http://dx.doi.org/10.1176/appi.ajp.2017.16010034

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Last Updated on April 4, 2017 by Marie Benz MD FAAD

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