For more than 20 years I’ve suffered from chronic depression. Medications help for a while, but the symptoms always return. I’ve heard of a relatively new treatment called Vagus Nerve Stimulation. What can you tell me about it and how can I find someone who provides this treatment?  

Vagus Nerve Stimulation (VNS) is the only FDA-approved implantable device ever approved for a psychiatric condition in the United States. VNS involves electrical stimulation of a nerve in the neck (Vagus) that goes up into the lower part of the brain. Recently published studies suggest that a subset (approximately one-third) of patients with severe depression which has failed treatment with four or more medications may respond to VNS. VNS involves surgical implantation of a small electronic stimulator under the collar bone. An electric lead is then attached to the vagus nerve. The stimulator “fires” small electrical impulses to the nerve on a regular cycle 24 hours a day. Many patients responding to VNS do so in a very slow manner: some patients take as long as nine to twelve months before responding. To be evaluated for VNS you must be screened by a qualified psychiatrist and have met the FDA requirements (failed response to four or more adequate dose/duration antidepressant trials). University medical centers are among the primary sites for VNS. Saint Louis University was the first site in St. Louis to provide VNS for depression, and arrangements for evaluation for VNS can be made by contacting our VNS clinic at 314-268-7280.  

Charles R. Conway, MD
Assistant Professor
Director, VNS Clinic
Saint Louis University School of Medicine

I lived in utter despair and hopelessness. In November of 2000, I became aware of a clinical trial for the investigation of vagus nerve stimulation (VNS) therapy for treatment-resistant depression. Once I learned that the procedure was safe, unrelated to brain surgery or ECT, I was eager to try it. I had absolutely nothing to lose. After a four-month review process, I was eventually included as a study subject and in April of 2001 I was implanted with the VNS Therapy System™.  It was a 90-minute out-patient procedure. The therapy worked very gradually over a period of six to nine months. I would call it a series of “up ticks.”  With each up tick, I was able to do a little bit more with my life until I ultimately achieved complete remission. The procedure is now FDA approved and can be performed by a neurosurgeon, vascular surgeon or ENT. A prescription from an M.D. is required. If you want to know more, I recommend you contact the manufacturer of the stimulator directly at 1-877-NOW-4VNS. If appropriate, a case manager will be assigned to help you through the process. I wish you the very best of luck. 

Charles E. Donovan, III
Author, Out of the Black Hole: The Patient’s Guide to Vagus Nerve Stimulation and Depression
St. Louis, MO
1-888-VAGUS-88

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