Can vagus nerve stimulation reverse depression?

Many people with depression struggle and are always searching for a treatment that lasts long. While drugs have been the primary therapy for depression, many people do not always respond to them. Even when they respond, the benefits are short lived and plus the drugs also have potent side effects.

Recently vagus nerve stimulation has been introduced as a treatment for depression. Vagus nerve stimulation has been used for the treatment of certain epileptic disorders. Over time, it became obvious that these individuals started to develop an improvement in their mood. So now vagal nerve stimulation is being tried as a therapy for chronic depression.

Vagal nerve stimulation is a small surgical procedure. A thin electrode is placed near the vagus nerve in the neck and the wire is then connected to a pulse generator, which is implanted in the upper chest. The pulse generator emits electrical signals which stimulates the vagus nerve. Vagus nerve stimulation in turn results in mood improvement- at least that is the theory.

Vagus nerve stimulation is not standard therapy and only used in people in whom the standard anti-depressant therapies have failed. In addition, vagus nerve stimulation may be an option for people who are taking multiple drugs and have failed electroconvulsive therapy. Unfortunately, vagus nerve stimulation does not work in all depressed people. The few studies have not always shown convincing results and the result are also variable. Even among psychiatrists, the therapy is not accepted and many health insurance companies do not cover the procedure. In addition, the costs of vagal nerve stimulation are not trivial- considering that it may not even work.

While the procedure is easy to perform, it does have side effects that range from neck pain, infection, damage to the vague nerve, difficulty breathing, nausea and slowing of heart rate. In rare cases, one may develop vocal cord paralysis, voice changes, persistent cough and throat pain. While most side effects are tolerable, many people find the side effects annoying in the long run. However, of more concern is that in a few cases, vagal nerve stimulation may also lead to worsening of depression, suicidal thoughts and anxiety.

The surgery for implantation of the device is done as an outpatient and done under local anesthesia. After implantation, the device is programmed to deliver electrical impulses at various frequencies. Most people are started at low electrical current, which is gradually increased to get the desired result. Each stimulation lasts 30 seconds and occurs every 5 minutes. During this period, the side effects are most common. All individuals are given a small hand-held magnet to control the device. The machine has to be turned off while eating or speaking.

The results of vagus nerve stimulation are not immediate and often take months before the desired electrical impulse is obtained. As soon as the stimulation stopped, the depressive symptoms return. The decision to undergo vagal nerve stimulation is difficult. The procedure is very costly and there is no guarantee it will work. So before you decide to get the procedure, speak to people who have had it done. Remember even after vagal stimulation, you may still need to take anti depressant medications and continue with psychotherapy.