Vagus nerve stimulation (VNS) is a treatment for epilepsy that was approved by the FDA in July 2005 for use with treatment-resistant depression. At the time, there was significant controversy about whether or not VNS actually works.

Like with electroconvulsive therapy (ECT), electrical charges help relieve the symptoms of depression. Unlike ECT, it involves the surgical implantation of a small device, but its effects may be longer lasting.

While VNS is still not very common, it may offer hope to people who haven't been able to control their depression with other treatments.

How Vagus Nerve Stimulation Works

During surgery for VNS, your surgeon will implant a small battery-powered device -- about the size of a silver dollar -- in your chest. It works like a pacemaker. Another incision is made on the left side of the neck and a thin wire (placed just under the skin) runs from the device to the large vagus nerve in your neck. The device sends out pulses of electricity into the nerve, which transmits them to the brain.

For reasons that doctors don't completely understand, these electrical impulses can relieve the symptoms of depression. They may affect the chemical balance of the brain. However, it could take several months before you feel the effects.

Whenever it's necessary, your doctor can change the settings on the device (essentially changing the dose) in the office with a programming wand. Usually, the device is set to go off at regular intervals. You can also turn it off using a special magnet.

Research into the effects of VNS on people with treatment-resistant depression has generally been positive. One long-term study of about 60 people with treatment-resistant depression was published in the Journal of Clinical Psychiatry in 2005. It showed that, after two years of treatment, 42% of the study group still had a positive response. And 22% -- also of the entire group -- had a complete remission of their symptoms.

VNS Risks and Side Effects

Possible side effects from VNS include temporary hoarseness, cough, and shortness of breath. Like any operation, the procedure poses some risks, including infection. Rarely, additional surgery might be necessary (if the wire shifts position or the device breaks down, for instance). Eventually, you will need surgery to replace the battery when it wears out.

VNS devices can interfere with mammograms. The device may also be damaged by defibrillation or ultrasound. The device must be turned off before having magnetic resonance imaging (MRI).

Even if you are treated with VNS, you will probably also continue other treatments for your depression, like depression medicine and therapy.

next: Vagus Nerve Stimulation for Chronic Treatment-Resistant Depression

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Reviewed: 3/2006