New care for frequent depression - depression
Vagus Nerve Stimulation for Continual Treatment-Resistant Depression
Vagus means "wandering" in Latin, and is the achieve category for the vagus nerve, the best ever nerve in the body. It averages more or less two feet in distance end to end and "wanders" all the way through the upper body. The vagus nerve starts in the brain, goes down the neck and into the body where if affects the vocal cords, the acid comfort of the stomach, the heart, the lungs, and other organs. In the brain it projects to areas alleged to be dependable for seizures, mood, appetite, recall and disquiet (note 3). However, the vagus nerve cord does not have many pain nerves, so stimulation of the vagus nerve is not painful, while some patients may feel some sensation when electrical pulses are generated.
When Vagus Nerve Stimulation was first agreed for epilepsy, some patients reported an convalescence in mood. Researchers categorical to blueprint a study exclusively to assess changes in a patient's mood and depression due to stimulation of the vagus nerve. In 1999, scientists began the first open label (no sop group) study for depression with 60 patients. This first study found that there was definitely an convalescence in mood for depressed patients. Based on this study, a more exhaustive and thorough study was intended to agree on if Vagus Nerve Stimulation would be a safe, allowable and effectual care for continual depression.
The a short time ago done one-year, amplify blind, excuse illicit trial had 235 patients from 21 participating hospitals in the United States, and showed clinically considerable improvements due to action compared to baseline (note 2). The acute (short-term) phase lasted three months, all through which half of the patients conventional stimulation (treatment group) and half did not (control group). The long-term phase of the study lasted an added 9 months (for one year total treatment) of stimulation. The HRSD-24 (24 item clinician-rated Hamilton Rating Scale for Depression) improvements experiential over the first year were approvingly significant. The consequences of this long-term, crucial study were submitted to FDA in October 2003; the FDA's conclusion on the use of Vagus Nerve Stimulation for depression is not anticipated already October 2004 (note 2). Of note, Vagus Nerve Stimulation therapy was permitted for use in patients with behavior challenging depression in the European Union in March 2001, and in Canada in April 2001 (note 2) .
The Pulse Generator (battery) delivers a small total of electrical in progress to the vagus nerve erratically (30 seconds on and five action off ) (note 3) 24 hours a day, 7 days a week for up to 10 years. The stimulation is delivered automatically, so the long-suffering does not have to do anything. As there is nil to remember, acquiescence is assured. The stimulation is not believed to be uncomfortable, and some patients do not even feel the stimulation. A nurse at the doctor's company can alter the level of stimulation (amount of electricity delivered) if the enduring ever feels uncomfortable. In the study at present being reviewed by the FDA, researchers noted numerous similarities among epileptic and depressed patients (note 4).
One of the most crucial similarities is that Vagus Nerve Stimulation behavior effectiveness improves over time. The longer the serene receives stimulation, the change for the better the results. In addition, both populations of patients share the following:
Vagus Nerve Stimulation is NOT brain surgery, even despite the fact that it is an omnipresent surgical course of action that changes the affair of the brain. The stimulator is a pacemaker-like apparatus that generates electrical pulses (Pulse Generator); it is set in under the skin in the left chest all through a small incision. While this may sound like a acute or perilous procedure, it is not. The FDA has accepted the use, and complete the protection of this procedure, and 22,000 patients have established the insert to treat epilepsy. The Vagus Nerve Stimulation surgery involves two small incisions, one in the chest and one at the buck part of the neck. At no time is the brain physically manipulated by the surgeon.
The surgery to establish the NCP Arrangement takes 45 log to two hours. Local, regional or all-purpose anesthesia (putting the enduring to sleep) is used all through the surgery; the physician and anesthetist agree on which type of anesthesia is best for each patient. Most Vagus Nerve Stimulation patients will have outpatient surgery, (note 3) but some patients may need to stay in the rest home overnight, and in that case they will need a category appendage or companion to take them home from the hospital.
What Happens After the Vagus Nerve Stimulation Surgery?
Most Vagus Nerve Stimulation patients go home the same day or the next day. You will feel some minor stiffness/soreness about the area of the embed for a few days. Your medical doctor may prescribe a minor pain medicine such as Tylenol with codeine. A week later your doctor will in all probability want to check the scars and a nurse can program/change the settings on the stimulator in the doctor's office.
Is the Vagus Nerve Stimulation Surgery final?
The Vagus Nerve Stimulator can be twisted off or detached (explanted) at any time if the enduring feels that it is not helping, or in the dubious event that the serene can't tolerate the stimulation. The contraption can be finally crooked off in less than 30 seconds in the doctor's office, all it takes is for a nurse to hold a programmable wand over the skin above the Pulse Generator. Explantation (removal) of the Vagus Nerve Stimulation appliance is also possible, however, less than one half of one percent of the 22,000 patients have designated to have the contraption removed. As for implantation, the surgery to amputate the appliance is a very austere procedure. Only the Pulse Generator is taken out of the body; attempting to cut off the electrode from about the vagus nerve could cause damage, and is not recommended.
2. Form 10-Q for Cyberonics Inc, September 4, 2003.
3. Vagus Nerve Stimulation Therapy Mechanisms of Action. September 24, 2003 presentation by M. S. George, MD. Medicinal Academe of South Carolina, Charleston, SC, USA.
4. The Investigation of Vagus Nerve Stimulation Therapy in Treatment-Resistant Depression. September 24, 2003 presentation by R. L. Rudolph, MD. Cyberonics, Inc.
Charles Donovan was a serene in the FDA investigational trial for vagus nerve stimulation and depression. He testified to the Panel at the Advisory Conference on June 15th. After 25 years of constant depression, vagus nerve stimulation finally cured his constant depression. The dramatist is so gratifying and humbled by this remarkable device. Learn more at his website: www. VagusNerveStimulator. com
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