Nerve Stimulator Appears Effective in Treatment-Resistant Depression
WebMD News Archive
"A typical side effect would be a raspy-sounding voice during
stimulation, because the [vocal cords are] also affected," says Rush. The
electrical current is on for 3 seconds and then off for 5 minutes, and this
cycle is constant 24 hours a day, Rush says. "At the same time, the patient
is maintained on the baseline medication regimen. This is an unusual approach
for psychiatry, but we are considering this as an add-on therapy," he
Although he is enthusiastic, Rush emphasizes the preliminary nature of the
findings. Asked to comment on the study, Thomas Thompson, MD, director of the
ECT program at Wesley Woods Geriatric Hospital in Atlanta and assistant
professor of psychiatry at Emory University School of Medicine, echoed that
cautious note. Thompson tells WebMD, "This is very preliminary work, and
the findings need to be replicated in a larger study. A lot more work still
needs to be done."
If the results are proven in larger studies (the FDA has given approval to
enroll another 30 patients in the ongoing trial), Rush says that the stimulator
may prove a good alternative to ECT. He says that he and his fellow researchers
did some testing that indicates the vagus nerve device may actually improve
some mental functioning.
One of the main criticisms of ECT is that it sometimes leaves patients with
sluggish responses and impaired memory. Rush says, however, that the
improvement may be related to the improvement in depression.
That explanation makes sense to Thompson, who says that although ECT is
associated with some changes in mental functioning around the time of the
treatments, "We actually see improvements when we retest after treatment if
there has been an improvement in the depression." He says that the vagus
nerve stimulator may work the same way.
Using the treatment for depression is experimental, but Rush estimates that
if it becomes an approved therapy the cost will be "about $10,000 to
$12,000 for the device and about $4,000 to $5,000 for the surgery." In this
study, all surgeries were "done by neurosurgeons who have implanted [the
vagus nerve stimulator] for epilepsy," Rush says.
The study was partially funded by Cyberonics of Houston, manufacturer of the