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Vagus nerve stimulation for treatment-resistant mood disorders: a long-term naturalistic study.

Albert U, Maina G, Aguglia A, Vitalucci A, Bogetto F, Fronda C, Ducati A, Lanotte M - BMC Psychiatry (2015)

Bottom Line: Response was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.Two patients withdrew from the study because of side effects or inefficacy of stimulation.Our case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.

View Article: PubMed Central - PubMed

Affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. umberto.albert@unito.it.

ABSTRACT

Background: Limited therapeutic options are available for patients with treatment-refractory major depression who do not respond to routinely available therapies. Vagus nerve stimulation showed adjunctive antidepressant effect in chronic treatment resistant depression, even though available studies rarely exceed 2-year follow up. We report a naturalistic 5-year follow up of five patients who received VNS implant for resistant depression (3 patients with major depressive disorder and 2 with bipolar disorder).

Methods: Response was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.

Results: Response and remission rates were both 40% (2/5) after 1 year, and 60% (3/5) at 5 years. Two patients withdrew from the study because of side effects or inefficacy of stimulation.

Conclusions: Our case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.

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Related in: MedlinePlus

HDRS, MADRS and CGI-S scores across time for Patient 1 (female, 66 years, Major Depressive Disorder, chronic MDE, no comorbid diagnoses).
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Fig4: HDRS, MADRS and CGI-S scores across time for Patient 1 (female, 66 years, Major Depressive Disorder, chronic MDE, no comorbid diagnoses).

Mentions: Table 2 shows results of the repeated measures ANOVA on the total scores of the HDRS, MADRS, CGI-S and SF-36 scales (all not statistically significant). Figures 1, 2, 3, 4 and 5 show individual scores for each patient and stimulation parameters, as patients had different outcomes over the 5-year follow-up. According to the HDRS-17, 2 patients were responders (40%) and remitters (40%) after 1 year of VNS treatment (patients 2 and 4). At 2 years, the three patients still on treatment were all responders and remitters. Two of the three patients who were followed-up for 5 years had one depressive recurrence during the 4th year and the third subject showed no recurrences for the whole period.Table 2


Vagus nerve stimulation for treatment-resistant mood disorders: a long-term naturalistic study.

Albert U, Maina G, Aguglia A, Vitalucci A, Bogetto F, Fronda C, Ducati A, Lanotte M - BMC Psychiatry (2015)

HDRS, MADRS and CGI-S scores across time for Patient 1 (female, 66 years, Major Depressive Disorder, chronic MDE, no comorbid diagnoses).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4384299&req=5

Fig4: HDRS, MADRS and CGI-S scores across time for Patient 1 (female, 66 years, Major Depressive Disorder, chronic MDE, no comorbid diagnoses).
Mentions: Table 2 shows results of the repeated measures ANOVA on the total scores of the HDRS, MADRS, CGI-S and SF-36 scales (all not statistically significant). Figures 1, 2, 3, 4 and 5 show individual scores for each patient and stimulation parameters, as patients had different outcomes over the 5-year follow-up. According to the HDRS-17, 2 patients were responders (40%) and remitters (40%) after 1 year of VNS treatment (patients 2 and 4). At 2 years, the three patients still on treatment were all responders and remitters. Two of the three patients who were followed-up for 5 years had one depressive recurrence during the 4th year and the third subject showed no recurrences for the whole period.Table 2

Bottom Line: Response was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.Two patients withdrew from the study because of side effects or inefficacy of stimulation.Our case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.

View Article: PubMed Central - PubMed

Affiliation: Rita Levi Montalcini Department of Neuroscience, Mood and Anxiety Disorders Unit, University of Torino, via Cherasco 11, 10126, Turin, Italy. umberto.albert@unito.it.

ABSTRACT

Background: Limited therapeutic options are available for patients with treatment-refractory major depression who do not respond to routinely available therapies. Vagus nerve stimulation showed adjunctive antidepressant effect in chronic treatment resistant depression, even though available studies rarely exceed 2-year follow up. We report a naturalistic 5-year follow up of five patients who received VNS implant for resistant depression (3 patients with major depressive disorder and 2 with bipolar disorder).

Methods: Response was defined as a reduction of the 17-item HDRS total score ≥50% with respect to baseline, remission as a score ≤7.

Results: Response and remission rates were both 40% (2/5) after 1 year, and 60% (3/5) at 5 years. Two patients withdrew from the study because of side effects or inefficacy of stimulation.

Conclusions: Our case series showed that long-term VNS may be effective in reducing severity of depression in a small but significant minority of patients, although two patients had stimulation terminated because of adverse effects and/or refusal to continue the study.

Show MeSH
Related in: MedlinePlus