Update on Neuromodulation for Treatment-Resistant Depression

Thomas E. Schlaepfer, Bettina Bewernick

Research output: Contribution to journalReview article

Abstract

About 30% of patients suffering from a major depressive disorder do not respond sufficiently to established pharmacological, psychotherapeutic, or somatic treatments. Advances in technology and emerging knowledge about the dysfunctional brain circuits underlying depression have led to the development of different neuromodulation techniques. The aim of the present review is to give an update on noninvasive techniques, such as electroconvulsive therapy (ECT), magnetic seizure therapy (MST), transcranial magnetic stimulation (TMS), and invasive techniques requiring brain surgery, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). First, the clinical relevance for therapy-resistant depression, including the current level of evidence, are presented. Neuroethics is concerned with the ethical, legal and social policy implications of neuroscience. A second focus of the review is the application of fundamental ethical principles, such as patient autonomy, patient well-being and justice to neuromodulation therapies. Due to reduced availability and lacking long-term efficacy data, most patients with treatment-resistant depression face a trial-and-error approach to therapeutics. This contravenes the ethical criteria of patient autonomy and justice. In order to raise the level of evidence, financial support of long-term studies, including large samples and randomized control trials, are necessary.

Original languageEnglish (US)
Article number1389
JournalF1000Research
Volume4
DOIs
StatePublished - 2015

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Treatment-Resistant Depressive Disorder
Brain
Social Justice
Surgery
Vagus Nerve Stimulation
Financial Support
Availability
Electroconvulsive Therapy
Deep Brain Stimulation
Transcranial Magnetic Stimulation
Major Depressive Disorder
Therapeutics
Public Policy
Neurosciences
Networks (circuits)
Seizures
Pharmacology
Depression
Technology

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Update on Neuromodulation for Treatment-Resistant Depression. / Schlaepfer, Thomas E.; Bewernick, Bettina.

In: F1000Research, Vol. 4, 1389, 2015.

Research output: Contribution to journalReview article

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