Posted by adamie on August 8, 2001, at 19:28:42
In reply to Re:VNS. » adamie, posted by JahL on August 8, 2001, at 15:28:55
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> > if meds fail then VNS will be for me. only side effect is voice alteration. it's a pace maker for the brain. Although it doesn't even touch the brain. it's a tiny box in your chest with a little cord going around your vegus nerve. this cord gives it a small pulse every 3-6 minutes which over weeks or months of time make you feel more normal. response rates for true treatment resistant patients is around 45%.
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> Do you know if 45% is a 'response' (ie 50% improvement) or a 'remission' rate?
>
> >nothing to lose.
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> Quite.
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> >if you're suicidal then move to canada
>
> Nice part of the world.
>
> Ta,
> J.I'm sorry if my message was somewhat rude.
Regarding VNS, if you are part of the 45% that it works for it is like a perminent improvement it creates for you (unless you take it out). the 45% is for I think response rates but for a good portion of that it has been remission. I just dont know the percentage. For those that VNS works for it is supossed to work very well. A lot of severely depressed people who's cases were severe enough for them not to be able to work or do other such things, many of them who responded to VNS have. Perhaps I will look for an article soon.
The improvement that the VNS does create is like a perminent one. Say without meds you can be very severely depressed. With VNS it can improve your situation so that without meds you may be just moderately depressed. This is just an example because of course the effect will vary. So then the meds will have to deal with a much milder which would be easier to treat. the way I am talking it seems too good to be true but I am just extremely convinced over this VNS and am actually going to try it myself if meds dont work well enough for me.
I really see it as perminently making your depression much more mild (unless you take out the VNS) and therefor the remaining depression more treatable by meds. But of course how much it works will vary.
There was a better study but this is one which I just found right now-
Background: Vagus nerve stimulation (VNSTM), as delivered by the NeuroCybernetic Prosthesis (NCP®) System, is an approved therapy for treatment-resistant epilepsy. We examined the safety and potential antidepressant effects of VNS for treatment-resistant, major depressive episodes (MDEs).
Methods: Adult outpatients ( n = 30) with nonpsychotic, treatment-resistant, major depressive ( n = 21) or bipolar I ( n = 4) or II ( n = 5) (depressed phase) disorder, whose current MDE was >2 years in duration or who had >4 MDEs in a lifetime and who also had failed at least 2 robust medication trials in the current MDE were eligible. Each participant completed up to a 4-week baseline (preimplantation) period, while on stable antidepressant regimens or while not taking antidepressants ( n = 5). Thereafter, the NCP System was implanted, followed by a 2-week, single-blind, recovery period (no stimulation). For the next 2 weeks, stimulation parameters were adjusted. Thereafter, VNS was provided at a fixed (maximum comfortably-tolerated) dose for 8 weeks.
Results: In the current MDE, patients had failed to respond to 2 ( n = 9), 3 ( n = 2), 4 ( n = 6), or >5 ( n = 13) robust antidepressant medication trials; 57% had also received ECT. Mean length of the current MDE was 10.3 years (median = 4.7) (range = 0.3-49.5). Baseline 28-item Hamilton Depression Rating Scale (HDRS28) scores averaged 38.0 >5.5. Response rates ( >50% reductions in baseline scores) were 40% by HDRS28, 50% by the Montgomery-Åsberg Depression Rating Scale (MADRS), or 40% by the Clinical Global Impressions-Improvement (CGI-I) (1 or 2). Several subscales of the Medical Outcomes Survey (MOS) Short-Form (SF-36) revealed substantial functional improvement in responders. As of this writing, improvements obtained acutely have been sustained in acute study responders seen in longer-term follow-up ( n = 10).
Conclusions: These positive open trial results in a severe, treatment-resistant patient group suggest that VNS is a safe and effective treatment for a significant proportion of these patients
57% of these patients actually had ECT. For such severely ill patienst I think VNS has worked amazingly well. At least it will make the remaining depression a lot easier to treat. take care. and sorry for over stating it as complete remission earlier, although for some that can be the case. take care
poster:adamie
thread:74195
URL: http://www.dr-bob.org/babble/20010804/msgs/74243.html