TY - JOUR
T1 - Vagus nerve stimulation for depression
T2 - Efficacy and safety in a European study
AU - Schlaepfer, T. E.
AU - Frick, C.
AU - Zobel, A.
AU - Maier, W.
AU - Heuser, I.
AU - Bajbouj, M.
AU - O'Keane, V.
AU - Corcoran, C.
AU - Adolfsson, R.
AU - Trimble, M.
AU - Rau, H.
AU - Hoff, H. J.
AU - Padberg, F.
AU - Müller-Siecheneder, F.
AU - Audenaert, K.
AU - Van Den Abbeele, D.
AU - Matthews, K.
AU - Christmas, D.
AU - Stanga, Z.
AU - Hasdemir, M.
PY - 2008/5
Y1 - 2008/5
N2 - Background. Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression. Method. An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically. Results. The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (≥50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset; 44% of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63% at 3 months of stimulation) and coughing (23%). Conclusions. VNS therapy was effective in reducing severity of depression; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study.
AB - Background. Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression. Method. An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically. Results. The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (≥50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset; 44% of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63% at 3 months of stimulation) and coughing (23%). Conclusions. VNS therapy was effective in reducing severity of depression; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study.
KW - Brain stimulation
KW - Major depression
KW - Treatment resistance
KW - Vagus nerve
UR - http://www.scopus.com/inward/record.url?scp=41649085179&partnerID=8YFLogxK
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U2 - 10.1017/S0033291707001924
DO - 10.1017/S0033291707001924
M3 - Article
C2 - 18177525
AN - SCOPUS:41649085179
VL - 38
SP - 651
EP - 661
JO - Psychological Medicine
JF - Psychological Medicine
SN - 0033-2917
IS - 5
ER -