Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes

Ziad Nahas, Lauren B. Marangell, Mustafa M. Husain, A. John Rush, Harold A. Sackeim, Sarah H. Lisanby, James M. Martinez, Mark S. George

Research output: Contribution to journalArticle

264 Scopus citations

Abstract

Background: Vagus nerve stimulation (VNS) had antidepressant effects in an initial open, acute phase pilot study of 59 participants in a treatment-resistant major depressive episode (MDE). We examined the effects of adjunctive VNS over 24 months in this cohort. Method: Adult outpatients (N = 59) with chronic or recurrent major depressive disorder or bipolar (I or II) disorder and experiencing a treatment-resistant, nonpsychotic MDE (DSM-IV criteria) received 2 years of VNS. Changes in psychotropic medications and VNS stimulus parameters were allowed only after the first 3 months. Response was defined as ≥ 50% reduction from the baseline 28-item Hamilton Rating Scale for Depression (HAM-D-28) total score, and remission was defined as a HAM-D-28 score ≤ 10. Results: Based on last observation carried forward analyses, HAM-D-28 response rates were 31% (18/59) after 3 months, 44% (26/59) after 1 year, and 42% (25/59) after 2 years of adjunctive VNS. Remission rates were 15% (9/59) at 3 months, 27% (16/59) at 1 year, and 22% (13/59) at 2 years. By 2 years, 2 deaths (unrelated to VNS) had occurred, 4 participants had withdrawn from the study, and 81% (48/59) were still receiving VNS. Longer-term VNS was generally well tolerated. Conclusion: These results suggest that patients with chronic or recurrent, treatment-resistant depression may show long-term benefit when treated with VNS.

Original languageEnglish (US)
Pages (from-to)1097-1104
Number of pages8
JournalJournal of Clinical Psychiatry
Volume66
Issue number9
DOIs
StatePublished - Sep 2005

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Nahas, Z., Marangell, L. B., Husain, M. M., Rush, A. J., Sackeim, H. A., Lisanby, S. H., Martinez, J. M., & George, M. S. (2005). Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. Journal of Clinical Psychiatry, 66(9), 1097-1104. https://doi.org/10.4088/JCP.v66n0902