In an attempt to reduce or stop seizures in epilepsy patients, doctors may have stumbled upon a new treatment for severe depression. Studies of the Vagal Nerve Stimulator (VNS), first approved by the fda in 1997 as a treatment for epilepsy, indicated that it positively affected patients' moods, regardless of whether their epilepsy improved. In a subsequent pilot study, four out of ten depressed patients with the device reported at least a 50 percent improvement in depression.
That's potentially good news for depression sufferers. At any given time, about one in 20 Americans (18 million)--and 340 million people worldwide--suffer from this illness. And Dr. Charles DeBattista, director of Stanford's Depression Clinic, says it is poised to become one of the leading causes of disability in the world, since it affects people in their most productive years.
Fortunately, about 70 or 80 percent of persons with depression respond well to medication and/or psychotherapy. But that still leaves many sufferers desperate for treatment. And for some, electroconvulsive therapy (ect) or electroshock is the only option available. While ECT is a far cry from the tortuous treatment depicted in One Flew Over the Cuckoo's Nest--Dr. DeBattista calls it "one of the most effective" non-pharmaceutical treatments--there are significant side effects, most notably cognitive problems and memory loss. Once treatment stops, depression often recurs. But researchers are hopeful that the VNS "pacemaker for the brain," which functions much like a heart pacemaker, might represent an alternative treatment to ect in the future. It may also be particularly helpful for the elderly and other patients who are intolerant of medications such as antidepressants.
Once implanted, a small generator, controlled externally by a magnetic wand, sends an electrical pulse to the vagus nerve at regular intervals, stimulating areas of the brain believed to affect mood. The surgery to install the device takes about one to two hours, according to Dr. DeBattista, costs about $15,000, and the batteries last up to 12 years.
Although the trials to study VNS's potential antidepressant effects are just beginning at Stanford and 19 other institutions, Stanford's Dr. John Barry, assistant professor of psychiatry and neurology, suggests that one outcome is likely: "We may understand a lot more about depression as a result of these studies.''
--Leslie Talmadge, '86
