Under the Knife for Depression

A radical new treatment for depression has recently begun to be utilized in the United States. It involves surgically implanting a pacemaker-like generator into the chest of a person who suffers from chronic depression who in the past has not responded to normal treatment such as medication and counselling.

In the last decade, here has been some significant advancement in the recognition and treatment of depression.  The long-term effects depression has on some sufferers, such as low self-esteem, irritability, anxiety, reduced sex drive and suicidal thoughts, have necessitated newer, stronger therapies. While many clinically depressed sufferers find relief with a combination of prescribed drugs and therapy, millions of people across the world are affected by severe depression that appears to be resistant to treatment. One possibility that has recently emerged is making quite a stir in the American health system.

A team of psychiatrists and neurosurgeons at the University of California is the first in the country to offer a radical new surgical alternative that has been fully approved by the Food and Drug Administration. Originally developed in 1997 as an adjunctive therapy for epilepsy, the Vagus Nerve Stimulator has been shown to have positive effects on chronic, untreatable depression.

VNS comes in the form of a pacemaker-like generator that is implanted in the chest sending mild, intermittent electrical pulses through the vagus nerve, also known as the body's information highway, in the neck up to the brain. These waves have the ability to modulate mood-regulating neurotransmitters such as serotonin, dopamine and norepinephrine. The main benefit of VNS is that it obviates the need for a drug-reliant treatment scheme.

The device is monitored in much the same way as an oral drug, sending precisely timed and measured doses of electrical stimulation to the brain twenty four hours a day. Early trials have shown a great deal of success within just a few months, and though results are delayed, they appear to be sustainable and improve with time. Patients are still recommended to undergo psychiatric evaluations and cognitive therapy throughout their treatment with VNS, while family support is also imperative.

There are several necessary stages between diagnosis of treatment-resistant depression and therapy through VNS. Patients must be over eighteen, have suffered from long-term, untreatable depression and have previously received medically-supervised and unsuccessful treatment at least four times (such as four different antidepressants). As with most extreme treatment options, there are possible side-effects associated with VNS surgery. These can include voice alteration, hoarseness, throat pain and persistent coughing, but relief can be found with simple pharmaceutical remedies.

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