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For many people who suffer from depression, the traditional treatments of therapy, antidepressant medications, and electroconvulsive therapy (shock treatments) offer little or no relief. It is estimated that 15-30% of those who suffer from depression are resistant to these treatments. For these people, their depression symptoms are debilitating, and many of them become suicidal.
Luckily, medical professionals are developing new depression treatments that are bringing relief to many patients whose depression has been resistant to traditional treatments. These new depression treatments are based on the fact that the brain operates through electrical signals. If those signals are altered, abnormalities can potentially be corrected. And the good news is that while these new procedures affect the brain, they’re not as invasive as brain surgery.
One type of new depression treatment is deep brain stimulation. It is many years from being FDA approved, but the surgery is being studied by researchers. A study conducted by a neurologist named Dr. Helen Mayberg showed that a particular area of the brain is overactive in people who are resistant to traditional depression treatments. Brain hyperactivity is also a symptom of other conditions, such as epilepsy and Parkinson's Disease, and scientists have treated these disorders by using electrodes to stimulate the overactive area of the brain. Dr. Mayberg's findings led her to try the same treatment on depression sufferers.
The treatment, called Deep Brain Stimulation (DBS), has brought significant relief to many of those who have participated in clinical trials. Besides relief from depressive symptoms, some patients have reported that colors became more vivid after DBS.
How does it work? Two tiny holes are drilled into the patient's skull so that electrodes can be implanted in the brain. Patients also have to have a battery implanted in their chests (for men) or stomachs (for women.) The battery powers the electrodes, which send a low stream of voltage to the affected area of the brain. This electrical charge seems to counteract the hyperactivity.
First developed in 1985, Transcranial Magnetic Stimulation (TMS) is another new depression treatment which, unlike DBS, strives to stimulate the hypoactive part of the brain in depressed patients. Studies have found that the prefrontal cortex is less active in depressed patients. Therefore, TMS uses an electromagnet coil, which is held above the head, to send a light current into the prefrontal cortex, stimulating the area that is hypoactive. Because the electromagnet coil is placed over the scalp and not inserted inside the brain, TMS is less invasive than DBS.
The current is about the same intensity as in an MRI (Magnetic Resonance Imaging) and somewhat similar to electroconvulsive therapy. But unlike electroconvulsive therapy, TMS doesn't require anesthesia, and no convulsions are induced in the patient.
Many patients participating in TMS studies have received relief from their depression symptoms, but there is some evidence that TMS may be more effective for younger people than for the elderly. TMS has not shown evidence that is effective for treating depression and is therefore not an FDA approved procedure for depression.
The only new depression treatment which is FDA approved is vagus nerve stimulation. Vagus Nerve Stimulation (VNS) refers to the longest nerve in the body — the vagus nerve — which runs from the brain throughout the torso. The vagus nerve cannot experience pain, so stimulating it with an implant is a painless procedure, except for some temporary discomfort which may be caused by the small incision required for the implant of the stimulator.
Vagus nerve stimulation uses a battery, called a Pulse Generator, which is inserted in the patient's upper left the chest. It delivers a small electrical current to the vagus nerve in the neck. The left vagus nerve in the neck has a direct pathway to the key areas of the brain implicated in depression. However the procedure is not related to brain surgery and the procedure is not performed near the brain. The incision is at the lowest fold of the patient's neck. One lead wire is tunneled underneath the skin and coiled around the left vagus nerve in the neck. The intensity of the current can be adjusted for comfort, and patients appear to get better after a period of time from the date the implant was placed. Even after five years, patients have shown more improvement after receiving VNS.
The procedure is quite simple, and most patients go home the same day. The most common complaint is some mild pain in the incision area and minor hoarseness that clear up in a short period of time.
VNS has had great success with many patients, and it has recently been approved by the FDA as a new depression treatment.
If VNS does not work for a particular patient, the current can be turned off, and the implants can certainly be removed as simply as they were implanted. So, while it may seem like a lot to go through to someone who does not suffer from depression, this new depression treatment offer hope to those who have tried everything to no avail. If you have suffered with depression for years, the possibility of relief greatly outweighs the risks, especially when those risks are quite minimal.
VNS has had great success with many patients, and it has recently been approved by the FDA as a new depression treatment. DBS and TMS, on the other hand, have not yet been approved by the FDA for the treatment of depression.
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