Pacemakers -- for Anxiety
Anxiety -- the Nerve
Reason for Hope
George says there is reason for hope.
For the last 10 years, VNS has been successful treating
patients with epilepsy who do not respond to conventional therapy. Stimulating
the vagus nerve appears to reduce the number of daily seizures such people
experience by up to 40% -- and some patients become completely seizure-free,
VNS was approved by the FDA for treatment-resistant epilepsy in
VNS has also shown promise in the treatment of depression. It
is approved for this use in Europe and in Canada, but not in the U.S.
In a report published last year in the Journal of the
Society of Biological Psychiatry, 30 people with depression, who were not
helped by common medications, received VNS. Forty percent of the patients
showed some improvement after the treatment, according to the study.
Remarkably, some patients appeared to have no depression at all
after the treatment.
"What got me interested was the fact that 20% to 25% of
patients were completely well after treatment," says George, a co-author of
the study. "Among people with treatment-resistant depression, you rarely
see complete remission. These were people who had failed on three or four
medications, and two-thirds of the group had had electroconvulsive therapy
[ECT, the so-called shock treatment]."
A new study will compare VNS to other treatments for
depression, and to no treatment. In the meantime, its apparent success with
depression whets his appetite for trying the therapy with other mood disorders,
George says he believes there is even more reason to believe
that VNS will be successful in treating anxiety because of the critical
interaction between physical responses in the body -- for instance, heart rate
and muscle spasms -- and the experience of fear or panic in the brain. That
entire interaction occurs through the vagus nerve.
"It makes a lot of sense that you could change that
interaction by manipulating the information through stimulation of the
vagus," George says.
Because VNS requires surgical implantation, it is far more
invasive than other electrical stimulation techniques, such as ECT or
transcranial magnetic stimulation (TMS), which don't require cutting the body.
And it is not cheap: The device and surgery cost approximately $20,000.
Other psychiatrists are intrigued by the success of VNS in
depression, but say its practical use as a treatment remains to be seen.
Richard Weiner, MD, leads the American Psychiatric Association's Committee on
"It's an invasive technique," Weiner tells WebMD.
"You need to have some justification for using it. It's never going to be
something people run to do first. The issue is, once you have gone through a
trial of medications, at what point do you use this?"
For Gray Scott, participating in George's study was a chance to
try a cutting-edge treatment that could prove a permanent solution to the
anxiety plaguing her for nearly a decade. If it doesn't work, Scott says she
will have the device removed. If it does, she will leave it in