Vagus nerve stimulation for depression
Vagus nerve stimulation for depression
Vagus nerve stimulation is a procedure that sends electrical impulses into your brain in an effort to improve depression symptoms. Sometimes called vagal nerve stimulation, vagus nerve stimulation is one of a few newer brain-stimulation methods designed to treat chronic depression when other treatments haven't worked.
There's one vagus nerve on each side of your body. Each nerve runs from your brainstem through your neck and down to your chest and abdomen.
With vagus nerve stimulation, a device called a pulse generator is surgically implanted in your chest. A wire threaded under your skin connects the pulse generator to the left vagus nerve in your neck. The pulse generator sends out electrical signals along the vagus nerve to your brain. These signals affect mood centers of your brain, which may improve depression symptoms.
Why it's done
Antidepressant medications, psychological counseling (psychotherapy) or electroconvulsive therapy (ECT) can improve depression in most people. But everyone's different, and for some people these standard depression treatments don't work very well. In such cases, vagus nerve stimulation may be added to standard treatments to help relieve symptoms.
When vagus nerve stimulation may be a good option
Vagus nerve stimulation doesn't always relieve depression
The possibility that vagus nerve stimulation might work to treat depression was identified when it was being studied in people with epilepsy. Researchers noticed that some people who were getting vagus nerve stimulation had an improved mood. This led to further studies, which have produced mixed results.
For most people, vagus nerve stimulation doesn't significantly ease depression symptoms. However, it does seem to make a significant difference for some people. However, results vary from person to person.
Some mental health experts don't recommend its use for depression at all, and most health insurance companies don't cover the procedure for depression treatment. This can be a concern, as the vagus nerve stimulation device and surgery to implant it is expensive.
Vagus nerve stimulation
In vagus nerve stimulation, an implanted pulse generator and lead wire stimulate parts of your brain to stabilize the abnormal electrical activity....
For most people, vagus nerve stimulation is safe. But it does have some risks, both from the surgery to implant the device and from the brain stimulation.
Side effects after surgery
For most people, side effects are tolerable. They may improve over time, but some side effects may be bothersome for as long as you use vagus nerve stimulation. Adjusting the electrical impulses can help minimize these effects. If side effects are intolerable, the device can be shut off temporarily or permanently.
How you prepare
Because vagus nerve stimulation is a relatively new depression treatment, carefully consider the pros and cons before using it. It's not known precisely how stimulation of the vagus nerve may improve depression. The long-term effects of vagus nerve stimulation are still being studied, and not all side effects may be known yet.
Make sure you know what all of your other treatment choices are and that you and your doctor both feel that vagus nerve stimulation is the best option for you. Ask your doctor exactly what you should expect during surgery and after the pulse generator is in place.
Before surgery, your doctor will do a physical examination. You may need blood tests or other tests to make sure you don't have any health concerns that might be a problem. Your doctor will have you start taking antibiotics before surgery to prevent infection. You may need to stop taking certain medications ahead of time, and your doctor may ask you not to eat the night before the procedure. When you set up your surgery appointment, make sure you're clear on exactly what steps you need to take.
What you can expect
During the surgery
The surgery itself doesn't involve your brain. The pulse generator is implanted in the upper left side of your chest. The device is meant to be a permanent implant, but it can be removed if necessary. The pulse generator is about the size of a stopwatch and runs on battery power. A lead wire is connected to the pulse generator. The lead wire is guided under your skin from your chest up to your neck, where it's attached to the left vagus nerve through a second incision.
After the procedure
Stimulation typically lasts for 30 seconds and occurs every five minutes. You may have some tingling sensations or slight pain in your neck during episodes of nerve stimulation.
You'll be given a hand-held magnetic device so that you can control the stimulation yourself. This enables you to temporarily turn off the vagus nerve stimulation, which may be necessary when you do activities such as public speaking, singing or exercising, or when you're eating if you have swallowing problems.
You must visit your doctor periodically to make sure that the pulse generator is working correctly and that it hasn't shifted out of position.
If vagus nerve stimulation works as hoped, your depression symptoms will improve or go away completely. It may take several months of treatment with vagus nerve stimulation before you notice any improvements in your depression symptoms.
Keep in mind that vagus nerve stimulation generally isn't meant to replace traditional treatments. You may still need to take antidepressant medication or attend psychotherapy appointments, for instance.
Last Updated: 2010-07-30
© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
Terms and conditions of use