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Abstract
The aim of the study was to assess safety and efficacy of transcutaneous vagus nerve stimulation (taVNS) as the method added to standard pharmacotherapy in the group of patients with treatment-resistant depression. We present results of pilot study involving the use of commercially available transcutaneous vagus nerve stimulators. With external, non-invasive nature of new solution, the patient is avoiding possible side effects of surgical operation. taVNS is a relatively new, noninvasive VNS method based on the location of afferent vagus nerve distribution on the surface of the ear. The pilot study group consisted of 5 patients with treatment-resistant depression. All patients suffered from severe depression with no response to appropriate courses of at least two different antidepressants. The assumed observation time was 12 weeks. The duration of stimulation was 4 hours/day, divided in 2 sessions. Mental state was assessed by clinician with the use of the Hamilton Depression Rating Scale (HAMD-17) and the Clinical Global Impression Scale (CGI). In 2 cases substantial improvement of mental state was observed (significant improvement in scoring scales, improvement of mood and drive, decrease of anxiety). 3 patients resigned from the study because of difficulties in handling devices. In 2 cases substantial improvement of mental state was observed (significant improvement in scoring scales, improvement of mood and drive, decrease of anxiety). 3 patients resigned from the study because of difficulties in handling devices.
Highlights
Depression is a common mental disorder worldwide, with more than 300 million people affected, and constitutes a leading cause of disability, negatively impacts the quality of life and increases the risk of suicide [1, 2].Pharmacotherapy with the use of antidepressants and psychotherapy are the most common treatment for depression
We present the results of a pilot study which assess the safety and efficacy of transcutaneous vagus nerve stimulation as the method added to the standard pharmacotherapy in the group of patients with treatment-resistant depression
A 55-year-old man diagnosed with bipolar disorder has been treated psychiatrically for 17 years; in the past he was treated with amitriptyline for a long time with good effect
Summary
Depression is a common mental disorder worldwide, with more than 300 million people affected, and constitutes a leading cause of disability, negatively impacts the quality of life and increases the risk of suicide [1, 2].Pharmacotherapy with the use of antidepressants and psychotherapy are the most common treatment for depression. Up to 15% of patients with depression suffer from drug-resistant depression defined as a lack of response to treatment with two consecutive antidepressants belonging to different groups, at the right dose and for the appropriate time [5, 6]. Such patients are proposed various pharmacological methods of treatment potentiation that may be associated with systemic side effects (e.g., metabolic abnormalities and sexual dysfunction) and limited efficacy. Considering the response rates, it seems that in the group of patients whose pharmacotherapy modifications did not cause the improvement of mental state, physical, non-pharmacological methods of depression treatment give a greater chance to obtain remission
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