What is vagus nerve stimulation (VNS)?

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Vagus nerve stimulation (VNS) assails mood disorders two ways: by stimulating the vagus nerve and affecting neurotransmitters. While the vagus nerve carries signals from the major organs to the brain, researchers have found that it also communicates with areas of the brain that affect mood, particularly depression. Because it does not contain pain fibers, stimulating it does not cause pain. Studies have demonstrated that VNS can alleviate some symptoms, particularly for those who have not responded well to medications. More encouraging, these beneficial results improve over time and continue long-term. While the Food and Drug Administration (FDA) approved the use of VNS for anyone over eighteen experiencing medication resistant depression, researchers are still studying its use in patients affected by bipolar disorder.

Procedure: Surgery is required for vagus nerve stimulation. The surgeon implants a small pulse generator (like a pacemaker) in the left side of the chest. The electrical pulses are carried through wires to the vagus nerve in the left of the neck. Programmed by a doctor, the pulse generator sends small pulses to the vagus nerve, which in turn delivers these signals to the brain. The dose can be adjusted to avoid or decrease any side effects a patient may experience.

Once the pulse generator is in place, the patient can use a special magnet to shut it off if certain situations or events arise.

Sides effects: VNS side effects, which occur only during the treatment, have proven to be mild to moderate. Even these tend to become less noticeable over time. Nevertheless, patients report experiencing:
  • temporary hoarseness or a change in voice tone
  • increased coughing
  • shortness of breath
  • tickle in the throat
  • weight gain and sleep disturbance occurs in less than 2% of patients
Common concerns: VNS does not affect sexual function or memory. Airport security systems, microwave ovens and cellular phones typically do not interfere with the function of the pulse generator. Travelers are wise, however, to carry an ID card indicating they're VNS patients in case of any concern or hassle by security personnel.
Vagus nerve stimulation (VNS) has been widely used since the 1990s for the treatment of medically refractory epilepsy. The procedure is also performed for the treatment of severe depression that is resistant to both antidepressant medications and electroconvulsive therapy. The VNS device stimulates the brain via the left vagus nerve, which lies in the neck, so that implantation of the device does not require exposure of the brain.
Vagus nerve stimulation (VNS) delivers a mild, preprogrammed electrical shock to the brain. This is done through a tiny battery-powered device, like a pacemaker, that is implanted under the skin on the left side of the chest. It is thought that this shock may help to correct imbalances of chemicals in the brain, similar to the way ECT works. VNS is approved by the Food and Drug Administration (FDA) for prevention of epileptic seizures. Side effects with this treatment may include shortness of breath, sore throat, and hoarseness.
Mark Moronell, MD
Cardiology (Cardiovascular Disease)
With vagus nerve stimulation (VNS), a tiny battery-powered device - like a pacemaker - is implanted under your skin on the left side of your chest. The VNS is preprogrammed to give a mild electrical "shock" to the brain. It is thought that this shock may help to correct imbalances of chemicals in the brain, similar to the way ECT works. Some scientific studies show that VNS benefits people with depression who cannot find relief with traditional antidepressants or other medications. Side effects with this treatment may include shortness of breath, sore throat, and hoarseness. VNS is approved by the Food and Drug Administration (FDA) for prevention of seizures in people with epilepsy. At this time, this treatment is not approved for use in people with depression.
Vagus nerve stimulation (VNS) was approved by the FDA for the long-term treatment of chronic major depression that has not responded to antidepressant treatments. VNS is performed with an electrical device like a pacemaker that is implanted in the chest. Electrical leads are connected to the vagus nerve in the neck. The vagus nerve sends impulses to the brain. VNS is indicated for the adjunctive long-term treatment of chronic (more than 2 years) or recurrent depression for people 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments. VNS is not a replacement for medications or electroconvulsive therapy (ECT), but it can be added onto other treatments for adjunctive therapy and long-term management.

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Depression Treatment

Because it is a multi-faceted condition, treatment for depression is multi-faceted as well. Minor depression can often be treated with therapy and a few simple lifestyle changes, while chronic or major depression treatment can req...

uire medication in addition to therapy. In some severe cases, electroconvulsive therapy (ECT) may be used. It's important to work with your mental health professional to determine which course of treatment for your type of depression is most appropriate.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.