Vagus nerve stimulation shows positive treatment effect in depression

Vagus nerve stimulation (VNS) shows a positive treatment effect and improved quality of life (QoL) among patients with treatment-resistant depression (TRD), according to two studies published online Dec. 18 in Brain Stimulation.

Charles R. Conway, M.D., from Washington University in St. Louis, and colleagues conducted a multicenter, double-blind trial involving 493 adults with treatment-resistant major depression who were randomly assigned to receive 12 months of active or no stimulation sham VNS; 88.4 percent of participants completed the trial. The researchers found that the percent time in Montgomery-Åsberg Depression Rating Scale response could not differentiate active from sham VNS. However, antidepressant benefits significantly favored active VNS based on ratings from on-site clinicians and offsite masked raters. Significantly more percent time in response on the Clinical Global Inventory-Impression and Quick Inventory of Depressive Symptomology-Self Report was seen with active VNS.

A. John Rush, M.D., from Duke-NUS Medical School in Singapore, and colleagues compared the effects of active versus sham VNS on QoL and function in TRD in a multicenter, randomized study involving 493 adult patients with four or more unsuccessful antidepressant treatment trials. The researchers found that active VNS was superior to sham in terms of mean change from baseline in the seven-item subset of the Quality-of-Life Enjoyment and Satisfaction Questionnaire (Mini-Q-LES-Q) and Work Productivity and Activity Impairment Questionnaire (WPAI) item 6 used as continuous variables; a similar trend was seen for Q-LES-Q. Based on the Mini-Q-LES-Q, WPAI item 6, and Q-LES-Q, active VNS was superior to sham in time spent in clinically meaningful benefit.

“What’s really important here is that patients themselves were reporting that their lives were improving,” Conway said in a statement.

Several authors disclosed ties to pharmaceutical and medical technology companies, including LivaNova; LivaNova funded the original study from which these findings were derived.

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