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      Vagus Nerve Stimulation in Treatment-Resistant Depression: Long-term Clinical Outcomes

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          Abstract

          I ntroduction

          Vagus nerve stimulation (VNS) is a neuromodulation technique approved for Treatment-Resistant Depression (TRD).Evidence regarding its long-term efficacy and safety is still scarce.

          Objectives

          To descriptively report a case series of 3 patients undergoing adjunctive VNS for TRD with an over 10-year follow-up.

          Methods

          We investigated outcomes of clinical interest in patients with ongoing VNS for at least 10 years after the device implantation. They had participated in a larger single-arm interventional study conducted at the University Hospital of Padua. They were diagnosed with chronic unipolar (1), recurrent unipolar (1), and bipolar (1) TRD.

          Results

          Our 3 cases had an average 14-year history of psychiatric disease before surgery. Afterward, all subjects achieved clinical remission within two years. 2 patients experienced relapses within the first 4 years of treatment (respectively, 1 and 2 episodes). The other case showed a recurrent trend of brief relapses every two years. Only 1 individual needed to be admitted to the psychiatric unit once. None of them committed suicidal attempts. Prescription of antidepressants remained almost unchanged after the first two years. 2 individuals improved and 1 maintained their working position. Common adverse events were voice alteration (3/3), neck pain (2/3), and cough (2/3).

          Conclusions

          Very few cases of 10-year VNS for TRD have been reported so far. For our subjects, VNS was most likely to have a major impact on the clinical course of the disease. This treatment can be a safe and effective adjunctive intervention in a subgroup of patients with TRD.

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          Author and article information

          Journal
          ScienceOpen Posters
          ScienceOpen
          16 February 2021
          Affiliations
          [1 ] Azienda Ospedaliera di Padova, Psychiatric Clinic, Padova, Italy; Azienda AULSS3 Serenissima, Venezia, Italy
          [2 ] U.O.C. di Neurochirurgia Pediatrica, Neuroscienze, Padova, Italy
          [3 ] Azienda Ospedaliera di Padova, Psychiatric Clinic, Padova, Italy
          Article
          10.14293/S2199-1006.1.SOR-.PPWJMQY.v1

          This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

          All data generated or analysed during this study are included in this published article (and its supplementary information files).

          Medicine

          TRD, VNS, Neuromodulation, Vagus Nerve Stimulation, Psychosurgery, Treatment-Resistant Depression

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