In those cases where typical or standard treatments for depression just are not working, a new option for treatment is available. However, the long-term effects of this new treatment are not known because the Food and Drug Administration only approved it in 2005. Brain stimulation is used to improve symptoms with this new procedure called vagus or vagal nerve stimulation.

Apparently, your body has two vagus nerves, one on each side of your body that run from your brainstem through your neck, down to your chest, and abdomen. Your central nervous system uses this nerve to send and receive information. It is the primary communication pathway between your major organs such as your heart, lungs, and intestines to your brain. Electrical impulses stimulate the vagus nerve and that somehow affects mood centers in the brain.

This procedure does require minor surgery. A device about the size of a stopwatch, called a pulse generator, is surgically implanted in the upper left side of your chest. It is intended to be a permanent implant. A lead wire that is connected to the pulse generator is then guided under the skin from the chest up through the neck and attached to the left vagus nerve. Electrical signals sent from the pulse generator travel through the vagus nerve and are delivered to the brain. The person using the implant usually doesn’t feel the sensations from the pulse generator.

Researchers don’t know exactly why or how the stimulation of the vagus nerve improves depression. However, the stimulation apparently alters the functioning in areas of the brain that affect mood regulation. Electrical impulses can be delivered to the vagus nerve at various durations, frequencies and currents by programming the pulse generator. The typical stimulation used lasts for 30 seconds and repeats every five minutes. The device is meant to be a permanent implant. It runs on battery power.

There are only three specific situations for which the FDA approved the use of vagus nerve stimulation. For the treatment of long-term, chronic depression, that lasts two years or more despite standard treatments. For recurrent or severe depression or depression that has not improved after using at least four other treatments.

Health problem or common side effects associated with vagus nerve stimulation include changes in voice, hoarseness, sore throat, cough, neck pain, breathing problems more prominent during exercise, difficulty swallowing, tingling, or prickling of the skin. Additional surgery may be required it the pulse generators moves in your body or malfunctions. However, it does not cause weight gain like some antidepressants do, nor does it cause memory problems, sleep disturbances, interactions with other medications or foods, or sexual problems.

Photo Credit
Plan of upper portions of glossopharyngeal, vagus, and accessory nerves.
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Wikipedia Copyright Tags 20th U.S. edition of Gray's Anatomy of the Human Body, originally published in 1918 and therefore lapsed into the public domain.