Vagus Nerve Stimulation for Depression

Vagus Nerve Stimulation is a surgical procedure in which an electrial device is implanting in the patient's chest and wired to major nerves. The nerves then receive shocks of electricity at controlled doses.

There has been a great deal of research on Vagus Nerve Stimulation for depression over the past 5 years. Sadly, the quality of research is very poor. There have been no studies comparing VNS to a placebo that in any way replicates the experience of having the procedure done. In fact, some authors admit that the treatment's efficacy could be mostly or all placebo response.

The experience of having major surgery is likely to lead to a high level of expectency on the part of the patient. The meaning and expectation as part of the ordeal of surgery might be entirely responsible for the therapeutic effects. In other words, the only way to know if this treatment has any specific effects would be to do the surgery on a group of people but not turn their devices on.

Until there is better research I cannot recommend this treatment for anyone.

Research

George, M. et al. Vagus nerve stimulation therapy: A research update. Neurology. 2002;59:S56-S61.

Reviews several trials of VNS on people suffering from depression. Finds strong positive evidence; however, none of the trials used a structurally equivalent placebo.

Sackeim, H. et al. Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression: Efficacy, Side Effects, and Predictors of Outcome. Neuropsychopharmacology. 2001–VOL.25, NO. 5.

Trial of VNS for depression with a placebo control. The authors admit that most or all of the treatment effects could be placebo,

Nahas, Z. et al. Two-Year Outcome of Vagus Nerve Stimulation (VNS) for Treatment of Major Depressive Episodes. J. Clin. Psychiatry. 2005; 66: 1097-1104.

Trial of VNS for depression without a placebo control.

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