Mono is fortunately very rare, but it is very dangerous. This life threatening disorder, which destroys the patient’s blood cells, gives the person a huge spleen and a high fever and severely compromises the immune system. With the new possibilities offered by stem cell research, doctors are position to offer experimental stem cell treatment to patients in this situation.

Experimental Procedure

When the patient with FIM didn’t respond to other treatment because of her compromised immune system, doctors suggested a stem cell transplant treatment. With no other option available, the patient, a young woman, who had been in and out of hospital for a few years, agreed to have this experimental stem cell transplant procedure. The transplant treatment conducted by dr. glen Kennedy, of the Brisbane hospital together with doctors from the QIMR, proved successful and she was able to live a normal life with a restored immune system. This experimental treatment may suitable for other sufferers of the Epstein Barr virus and could offer hope for other similar diseases.

The research, published in the journal for clinical infectious diseases, is the first of type for EBV. Epstein-Barr- virus (EBV) is one of the most common viruses in humans. Nearly all adults in developed countries such as the United States having been infected, and30 to 40 percent of adolescences who contract the virus develop infectious mononucleosis.

Investigating stem cell and modified white blood cells treatment offers ways to possibly control and treat chronic EBV which research shows may be a genetically related disease. Numerous clinical trials are in progress to see the effectiveness of this type of treatment for the different forms of mono, including CMV.

Cancer and EBV

Research into EBV also shows how cells with the EBV virus can transform otherwise benign cells into cancer producing cells. This research was conducted by University of north Carolina School of medicine and published in the proceeding of the national academy of sciences. As scientists start to understand exactly how the EBV virus can take control of cells, the possibility of finding a cure not only for EBV but also for certain types of cancer gets ever closer.

Medical Trials

If you are suffering with EBV, ask your specialist if there are any clinical trials available in your area that you could participate in. remember to make sure you understand all the implications of participating in medical trial before you agree.

As we grow older, our bones become weak due to decline in bone mass. These fragile bones are prone to fractures easily. This phenomenon of weakening of bones is called as osteoporosis.

Osteoporosis can happen at any age however it is prevalent in older patients. Depression is found to accelerate the process of osteoporosis in older adults.

How are depression and osteoporosis related?

Researchers have revealed that older people who have depression possess lower bone mass as compared to normal older people. Bone mass is the amount of calcium present in the bones.

Risk Factors for low bone mass

  • Younger women who have depression
  • Women with mild depression who have not yet reached menopause
  • Being women
  • Older men with depression

Due to presence of osteoporosis, patients have to adopt several lifestyle changes which eventually cause symptoms of depression.

  • Osteoporosis patients may not be able to take part in activities that were once enjoyable due to fear of fracture of fragile bones.
  • Difficulty in performing everyday tasks
  • Loss of independence
  • Fear of going to crowded places for fear of fracturing a bone

Symptoms of depression in patients with Osteoporosis

Patients who are suffering from osteoporosis may experience various symptoms of depression.

Patient may not observe some of these symptoms; however his/her friends or family members may notice them.

  • Feeling of worthlessness, sad mood
  • Difficulty in concentrating
  • Difficulty in sleeping (too much sleep or too less sleep)
  • Loss of appetite
  • Tendency to eat more or loss of appetite
  • Lack of energy or fatigue
  • Lack of interest in enjoying tasks that were once pleasurable
  • Difficulty in concentrating
  • Suicidal tendency
  • Lack of self esteem
  • Increasing intake of alcohol, drugs, or tobacco

Diagnostic Tests for Depression in patients with heart diseases

The diagnosis of the major depression is performed by doctors after thorough medical examination of the depressed patient.  Patient is asked various questions related to medical history and symptoms.

Common Diagnostic Procedures

  • Full patient medical history
  • Physical Assessment
  • Thorough evaluation of symptoms
  •  Standardized questionnaires

Treatment of depression in patients with osteoporosis

Psychiatrists treat the depression in patients with osteoporosis by employing combination of various therapies for obtaining the desired results.

  • Medications like antidepressants and antipsychotic medications

Selective serotonin reuptake inhibitor (SSRI) including citalopram, sertraline, and fluoxetine

Serotonin and nor epinephrine reuptake inhibitor (SNRI) including venlafaxine and duloxetine

Antidepressants medications take many weeks to show their results. Psychiatrists usually combine medications with other therapies such as Cognitive-behavioural therapy or ongoing talk therapy.

The dosage of these medications may be adjusted depending on the patient’s response for reducing the side effects and achieving the optimal results.

  • Cognitive-behavioural therapy/ Psychotherapy/ or talk therapy
  • Physical exercise
  • Support from families/friends
  • Lifestyle changes including regular aerobic exercises that boost the patient’s mood
  • Medications for building new bones and stopping bone loss

Psychiatrists recommend exercise as an important part of osteoporosis treatment. Exercise helps in treatment by following ways.

  • Strengthen bones and muscles for preventing fractures
  • Boosting mood of patients by treating depression

Pain that simply does not go away is termed as Chronic pain. In some cases, it may lasts for even few years.  Your regular pain killer does not offer relief in chronic pain.

Chronic pain usually results due to long term disease, injury or infection. However it may result without any apparent reason.

There is no known underlying reason for depression due to chronic pain. However, chronic pain interferes with regular activities of individuals, causes sleep disturbances and reduces quality of life.

As per researchers, chronic pain often leads to worsening of depression symptoms. Moreover, it is one of the risk factors for suicide in depressed patients.

How chronic pain causes depression?

The severity of depression often increases with intensity of pain.

Depressed people have higher levels of cytokines that are responsible for intensity and length of immune system response to any infection.

These cytokines lead to inflammation (body response to infection) and thereby produces pain in the body. Here pain manifests as a sign of inflammation.

Inflammation is thought to play a significant role in depression linked to chronic pain.

Fibromyalgia and Depression

Fibromyalgia is often associated with depression. A patient suffering from fibromyalgia experiences chronic and widespread pain in muscles and multiple tender points on body.

Studies have revealed that patients with fibromyalgia are more prone to mental disorders including depression compared to other normal individuals.

Diagnostic Tests for Depression in patients with chronic pain

The diagnosis of the depression in patients with chronic pain is performed by psychiatrists after thorough medical examination of the depressed patient.

Psychiatrists may ask wide range of questions from the patient to ascertain various possible reasons for depression.

Diagnostic Procedures

•             Full patient medical history

•             Physical Assessment

•             Thorough evaluation of symptoms

•             Standardized questionnaires

Blood Tests and other laboratory tests may be performed for ruling out other causes of depression.

Symptoms of depression in patients with chronic pain

Patients who are suffering from chronic pain may experience various symptoms of depression.

Patient may not observe some of these symptoms; however his/her friends or family members may notice them.

  • Feeling of worthlessness, sad mood
  • Difficulty in concentrating
  • Difficulty in sleeping (too much sleep or too less sleep)
  • Loss of appetite
  • Tendency to eat more or loss of appetite
  • Lack of energy or fatigue
  • Lack of interest in enjoying tasks that were once pleasurable
  • Difficulty in concentrating
  • Suicidal tendency
  • Lack of self esteem
  • Increasing intake of alcohol, drugs, or tobacco

Treatment of depression in patients with chronic pain

Psychiatrists treat the depression in patients with chronic pain by targeting the underlying cause of

chronic pain.

Psychiatrists employ combination of various therapies for obtaining the desired results.

  • Medications like antidepressants and antipsychotic medication including Selective serotonin reuptake inhibitor (SSRI) and Serotonin and nor epinephrine reuptake inhibitor (SNRI)
  • Cognitive-behavioural therapy/ Psychotherapy/ or talk therapy
  • Physical exercise
  • Support from families/friends
  • Lifestyle changes including regular aerobic exercises that boost the patient’s mood

Major depression with psychotic features

Major depression with psychotic features is a serious depression that is characterised by the hallucinations and loss of reality (psychosis).  Patient is not only depressed but also develops

delusions.

Major depression causes profound effect on the lifestyle of affected patients who find it difficult to work, eat, sleep, concentrate and enjoy social activities.

Causes of Major Depression with Psychosis

The exact cause of Major Depression with Psychosis is not known. However there are certain risk factors that make a patient more vulnerable to this disease.

Risk factors that trigger Major depression with Psychosis in individuals

•             Individuals with family history of depression or psychotic illness

•             Individuals who have had traumatic childhood experiences

•             Individuals with family history of alcoholism

•             Individuals with biological family members who have had committed suicide

•             Individuals who have faced unfortunate life events like death of loved ones, divorce,

•             Individuals who have experienced major life changes such as job change, retirement

•             Individuals who have experienced physical, sexual, or emotional abuse

•             Individuals who have had failed personal relationships

•             Postpartum depression in women who have given birth to child recently

•             Individuals with low self-esteem and feelings of being deprived

•             Individuals who are addicted to alcohol, nicotine or illicit drugs

Symptoms of Major Depression with Psychosis

Patients who have Major Depression with Psychosis are characterised by the occurrence of major depressive episode lasting for entire day for at least two weeks. They also exhibit symptoms of psychosis.

•             Delusions involving false beliefs regarding one’s identity and locations

•             Hallucinations involving seeing or hearing unrealistic things

•             Depressed mood

•             Lack of interest in activities that were once pleasurable

•             Significant weight loss or weight gain

•             Difficulty in sleeping

•             Excessive movement or slowing down

•             Fatigue

•             Feeling of worthlessness or guilt

•             Difficulty in concentrating or making decisions

•             Suicidal thoughts

Patients usually exhibit the delusions and hallucinations associated with their depressed feelings.

Diagnostic Tests for Major Depression with Psychosis

The diagnosis of the major depression is performed by doctors after thorough medical examination of the depressed patient.  Patient is asked various questions related to medical history and symptoms.

Common Diagnostic Procedures

•             Full patient medical history

•             Physical Assessment

•             Thorough evaluation of symptoms

•             Standardized questionnaires like Hamilton Rating Scale for Depression, and the Beck Depression Inventory

•             Blood tests for TSH and thyroxin levels for excluding hypothyroidism

•             Basic electrolytes and serum calcium for ruling out metabolic disturbances

•             Full blood count including ESR for ruling out a systemic infection

•             Adverse affective reactions for medications

•             Adverse affective reactions for alcohol misuse

•             Evaluation of Testosterone levels for diagnosing hypogonadism

Treatment of Major Depression with Psychosis

Patients who have major depression with psychosis require immediate medical care and treatment.

There are various treatment therapies available for treating Major Depression. The doctors usually employ the combination of various therapies to obtain the optimal results

•             Medications like antidepressants and antipsychotic medication

•             Cognitive-behavioural therapy/ Psychotherapy

•             Physical exercise

•             Electroconvulsive therapy (ECT)

•             Vagus nerve stimulation

•             Tran cranial magnetic stimulation (TMS)

•             Lifestyle and home remedies

•             Herbal remedies and supplements

•             Mind-body connections

•             Coping and support

Depression is linked to various medical conditions especially those related to brain disorders.

Alzheimer is one such brain disease that causes depression in affected patients.

Alzheimer is a type of dementia characterised by difficulty in remembering, communicating and learning.  It occurs due to damage of the brain cells inside patient’s brain.

How depression originates in Alzheimer’s patients?

As patients suffering from Alzheimer find it difficult to memorise or communicate, they are not able to take proper care of themselves. It results in behavioural changes and mood disorders in these patients.

Patients who have Alzheimer become more depressed on realizing that their symptoms are getting worse.

Depression is not only a common occurrence in Alzheimer’s patients, but it also enhances the severity of the Alzheimer symptoms.

Symptoms of Depression in Alzheimer’s patients

Have you seen a patient suffering from Alzheimer disease? Try to look out for the following signs and symptoms to check if he/she is depressed.

  • Reluctant to act, move or perform any task (Apathy)
  • Showing lack of self esteem, sadness or worthlessness
  • Weight loss or weight gain
  • Sleep disturbances including too less or too much sleep
  • Sudden mood fluctuations
  • State of confusion
  • Getting unusually emotional (started crying or getting angry)
  • Remaining in isolation
  • Do not want to take any personal care
  • Refusal to take medications
  • Aimless wandering
  • Lack of pleasure in activities that were once enjoyable

It is difficult to distinguish between the symptoms of Alzheimer’s disease and depression separately. You should consult with your psychiatrist to confirm if the patient suffering from Alzheimer’s disease is also depressed.

Diagnosis of Depression in Alzheimer patients

The diagnosis of depression in Alzheimer patients is performed by experienced psychiatrist. He/she

may ask various questions to Alzheimer patients about their signs and symptoms of depression.

Psychiatrist may perform the thorough medical examination of the patient. Patient many be asked to conduct blood tests for ruling out any other medical cause of depression.

Psychiatrists may also ask the family members of patient if they have observed any changed behaviours in the patient.

Common Diagnostic Procedures

•             Full patient medical history

•             Physical Assessment

•             Thorough evaluation of symptoms

•             Standardized questionnaires like Hamilton Rating Scale for Depression, and the Beck Depression Inventory

Laboratory tests for ruling out other medical causes

•             Blood tests for TSH and thyroxin levels for excluding hypothyroidism

•             Basic electrolytes and serum calcium for ruling out metabolic disturbances

•             Full blood count including ESR for ruling out a systemic infection

•             Adverse affective reactions for alcohol misuse

Treatment of Depression in Alzheimer’s patients

Psychiatrist usually prescribes antidepressant medicines for improving the symptoms of depression in Alzheimer patients.

Antidepressant medicines are effective in improving the depression symptoms however they do have some side effects also. Psychiatrist usually prescribes those medications that provide maximum benefits at minimum risks.

The dosages of these medications are also adjusted in Alzheimer’s patients and their effects are carefully monitored.

The doctors usually employ the combination of various therapies to obtain the optimal results.

  • Medications like antidepressants and antipsychotic medication
  • Cognitive-behavioural therapy/ Psychotherapy
  • Physical exercise
  • Support from families/friends

Tips for Depression in Alzheimer’s patients

  • Maintain a strict daily routine of activities
  • Take all your medications on time and complete their dosage
  • Stay away from loud noises
  • Avoid stress and various situations that trigger stress
  • Socialise with people who have positive attitude
  • Make a support group of friends and family members
  • Engage in enjoyable activities like going to park, painting, gardening, etc
  • Ask for help if required
  • Take time out to spend with your relatives and friends

Have you observed the signs of depression in individuals who have had heart attack?

As per researchers, heart attacks (or other heart diseases) play significant role in causing depression in people who have had these heart diseases. Studies have shown that people who have heart disease are more vulnerable to depression compared to otherwise healthy people.

Why heart attack or other heart diseases cause depression?

The exact cause of depression in patients, who have heart diseases, is not known. However depression may further worsens the symptoms of heart disease as it can reduce the physical and mental health of patients.

Depressed patients tend to ignore their medication plan and skip the treatment for heart disease.

It puts them at higher risk of death after a heart attack.

Causes of depression in patients who have heart diseases

• Biological differences may result from chemical or physical changes in the brains of affected people and lead to depression.

• Neurotransmitters are naturally occurring brain chemicals, associated with the fluctuations in the mood of the person. The neurotransmitters are supposed to play significant part in causing depression.

• The hormones may trigger depression depending on the changes in their levels in the body. There are various factors that brought about changes in hormone levels such as menopause, thyroid problems, etc.

Diagnostic Tests for Depression in patients with heart diseases

The diagnosis of the major depression is performed by doctors after thorough medical examination of the depressed patient.  Patient is asked various questions related to medical history and symptoms.

Common Diagnostic Procedures

• Full patient medical history

• Physical Assessment

• Thorough evaluation of symptoms

• Standardized questionnaires like Hamilton Rating Scale for Depression, and the Beck Depression Inventory

• Blood tests for TSH and thyroxin levels for excluding hypothyroidism

• Basic electrolytes and serum calcium for ruling out metabolic disturbances

• Full blood count including ESR for ruling out a systemic infection

• Adverse affective reactions for medications

• Adverse affective reactions for alcohol misuse

•  Evaluation of Testosterone levels for diagnosing hypogonadism

Signs and Symptoms of Depression in patients with heart diseases

Sadness

Feeling of worthlessness, hopelessness

Feeling irritable or restlessness

Loss of interest in activities that were once pleasurable

Feeling tired frequently

Difficulty in concentrating

Difficulty in making decisions

Loss of memory

Loss of appetite

Suicidal tendency

Treatment of depression in people with heart disease

Psychiatrists treat the depression by employing the combination of various therapies to obtain the optimal results.

• Medications like antidepressants and antipsychotic medication

Selective serotonin reuptake inhibitor (SSRI) such as citalopram, sertraline, and fluoxetine

Serotonin and norepinephrine reuptake inhibitor (SNRI) such as venlafaxine and duloxetine

• Cognitive-behavioural therapy/ Psychotherapy/ or talk therapy that inculcates the positive attitude and behaviours in the patients

• Physical exercise

• Support from families/friends

Tips for treating depression in heart disease patients

• Exercise regularly and remain physical active

• Eating healthy foods

• Take interest in pleasurable activities

• Maintain proper sleeping habits

• Minimize use of alcohol and other illegal drugs

• Quit smoking

• Get engage in socialising activities

• Express feelings to close friends and family

• Maintain strict regimen of taking medications

When people get old they are more prone to depression. In fact, depression is a common disease in elderly individuals.

Usually, depression in elderly goes untreated as people don’t consider it seriously. It is characterised by persistent feelings of sadness and a lack of self-esteem.

Causes of depression in elderly

Elderly individuals are vulnerable to depression due to various life changes faced by them. These changes not only make them depressed but also enhance the severity of symptoms if already present.

Common causes of depression

•             Change in the location of residence after retirement

•             Pain of separation from children

•             Feelings of isolation or loneliness after death of children

•             Inability to do various activities such as driving or running

•             Associated illnesses or chronic pain

•             Difficult to concentrate or think clearly

•             Loss of memory

•             Depression linked with drug or alcohol abuse

•             Depression linked with physical illnesses such as thyroid disorders, heart disease, Parkinson’s disease, or stroke.

•             Depression as a part of dementia

•             Depression as side effect of many medications

There is lack of awareness in many older people about depression. In majority of cases, older people do not see doctor for treating the symptoms of depression as they consider it as normal phenomenon.

Symptoms of Depression in Elderly

The symptoms of depression in the elderly are not easily identified. Most of the depression symptoms in elderly are similar to the symptoms of depression in other individuals.

•  Fatigue

•  Loss of appetite

•  Difficulty in sleeping

•  State of confusion

•  Loss of memory

•  Changes in eating habits or loss of appetite

•  Loss of interest in activities that were once pleasurable

•  Irritable moods

•  Not taking shower or avoid shaving

•  Dirty and wrinkled clothes

•  Tendency to remain isolated or Withdrawing from others

•  Avoiding medications

•  Not answering phone calls

Diagnostic tests for depression in elderly

Psychiatrists may ask various questions to elderly patients about their symptoms of depression.

The diagnosis of the depression in elderly patients is performed by doctors after thorough medical examination of the depressed patient. Patient is also asked to conduct blood tests for ruling out any other medical cause of depression.

Common Diagnostic Procedures

•  Full patient medical history

•  Physical Assessment

•  Thorough evaluation of symptoms

•  Standardized questionnaires like Hamilton Rating Scale for Depression, and the Beck Depression Inventory

Laboratory tests for ruling out other medical causes

•  Blood tests for TSH and thyroxin levels for excluding hypothyroidism

•  Basic electrolytes and serum calcium for ruling out metabolic disturbances

•  Full blood count including ESR for ruling out a systemic infection

• Adverse affective reactions for alcohol misuse

Treatment for depression in elderly

In older people suffering from depression, doctor first treats any underlying physical illnesses

that may be causing depression.

The antidepressants usually cause more side effects in elderly patients therefore psychiatrists prescribe the medications which provide maximum benefits with minimum side effects.

The dosages of these medications are also adjusted in elderly patients and their effects are carefully monitored.

The doctors usually employ the combination of various therapies to obtain the optimal results.

•  Medications like antidepressants and antipsychotic medication

•  Cognitive-behavioural therapy/ Psychotherapy

•  Physical exercise

•  Support from families/friends

Tips for elderly patients with depression

•  Elderly patient should adopt positive changes in their lifestyle

•  Exercise regularly and remain physical active

•  Take interest in pleasurable activities

•  Maintain proper sleeping habits

•  Minimize use of alcohol and other illegal drugs

•  Get engage in socialising activities

•  Express feelings to close friends and family

•  Maintain strict regimen of taking medications

Treatment resistant depression is usually treated by performing electroconvulsive therapy (ECT) in patients with severe depression. However there are certain side effects associated with electric shocks in ECT.

Magnetic Seizure Therapy is an electrical brain stimulation therapy that has emerged as a safer alternative to ECT.

During MST, the seizures are induced by using magnetic fields instead of using electric shocks as in ECT. It involves rapidly alternating strong magnetic fields that allows greater control of intra-cerebral current intensity.

Studies done with MST have proved that it is an effective anti depressive treatment without any side effects. Moreover it promises faster recovery of orientation than ECT.

Magnetic Seizure Therapy Procedure

The magnetic seizure therapy is performed in similar manner as regular ECT treatment. It is a relatively a safe procedure where Magnetic seizures are elicited under general anaesthesia.

  • Patient is administered with general anaesthesia before the procedure
  • During anaesthesia, patient is oxygenated with 100 % oxygen
  • Therapist assess the motor activity of the right foot for tracking the duration of motor seizures
  • An EEG device is used for obtaining the bilateral frontal-mastoid EEG recordings.
  • A magnetic stimulator is used for delivering the treatments by employing highly efficient “Twin Coil”
  • Parameters of stimulation are as follows

Stimulation repetition rate: 100 pps

Number of pulses: 100-600 (duration 1-6s)

Stimulation amplitude: 100%

Patients are administered with two MST sessions every week. MST has proven to offer better acute side effect profile than ECT.

The magnetic fields induced by MST reaches the targeted areas of brain without any hindrance. Moreover, it allows better seizure initiation and improved control over the site of stimulation than ECT.

MST was introduced for minimizing the cognitive side effects of ECT. MST does so by inducing more focal seizure in the area of prefrontal cortex.

Thus, it is more effective in inducing seizures in targeted area without involving other region of brain including hippocampus and deep brain structures.

Using magnetic fields for stimulating the nerve cells in brain can lead to the improvement in symptoms of depression. This procedure is called as Transcranial magnetic stimulation.

Transcranial magnetic stimulation is a relatively new procedure that is recommended in patients who do not respond to other standard treatments such as medications and psychotherapy.

Although the exact role played by transcranial magnetic stimulation in relieving depression is not clear, the magnetic pulses stimulate the nerve cells in brain and thereby improve the depression symptoms in patients.

Preparation for Transcranial Magnetic Stimulation

Transcranial magnetic stimulation is performed as an outpatient procedure in doctor’s office. There is no elaborative preparation needed as it is non-invasive procedure that doesn’t require anaesthesia.

  • Your psychiatrist will perform complete physical examination before surgery to ensure that it is a safe for you.
  • You may be asked to conduct blood tests or other laboratory tests to ascertain that you are medically fit for the procedure
  • You should inform your doctor regarding any medications you are taking as you may be asked to stop or adjust the doses of certain medications before the surgery
  • You should inform your doctor if you are pregnant or planning to get pregnant.
  • You should inform your doctor if there are any implanted metallic devices in your body because Transcranial magnetic stimulation is not recommended in such cases.
  • You should also inform the doctor of any previous surgeries or associated health conditions.

Duration of Transcranial magnetic stimulation

Patient needs a series of treatment sessions for optimal results. The procedure is usually performed daily at least five times a week for 5 to 6 weeks.

Transcranial magnetic stimulation procedure

Before the procedure, the psychiatrist identifies the most suitable region for placing the magnets on your head. Moreover, psychiatrist also decides about the optimal dose of magnetic energy for the treatment.

  • You may be asked to sit comfortably in a reclining chair and wear earplugs during the treatment.
  • Psychiatrist places an electromagnetic coil against your head. He/she switches the electromagnetic coil off and on repeatedly couple of times for producing stimulating pulses.  It causes a tapping sound that lasts only for few seconds followed by pause.
  • Doctor will determine the appropriate dosage of magnetic energy required and increases the magnetic dose until your fingers or hands begin to twitch.
  • Depending on your symptoms and side effects, the amount of stimulation is changed during the procedure.
  • After the placement and dose of electromagnetic coil are determined, your treatment begins and it lasts for about 40 minutes.

Risks of Transcranial magnetic stimulation

The Transcranial magnetic stimulation is a relatively safe procedure and causes mild side effects.

Most of these side effects are short term in nature and usually improve after the first week or two of treatment.

Common Side Effects

  • Headache
  • Lightheadedness
  • Spasms or twitching of facial muscles
  • Scalp discomfort at the site of stimulation
  • Tingling

Complications

In some rare cases, the procedure may lead to certain serious side effects.

  • Seizures
  • Mania in patients with bipolar disorder
  • Hearing loss due to inadequate ear protection

Results of Transcranial magnetic stimulation

  • In majority of the cases, depression symptoms will improve or diminish completely.
  • The optimal results are obtained after several weeks of treatment
  • Patient should continue to take antidepressant medication or attend psychotherapy sessions even after transcranial magnetic stimulation.
  • The effectiveness of transcranial magnetic stimulation may improve once the optimal sites for stimulation and numbers of stimulations needed are identified.

Brain Stimulation methods have been used successfully as effective treatment options for improving symptoms of chronic depression. They are usually recommended in patients who do not respond to other treatments.

A Vagus Nerve Stimulation is newly designed brain stimulation procedure where electrical impulses are sent into the patient’s brain for treating depression symptoms.

What is vagus nerve?

On each side of our body, a vagus nerve runs from brain through neck and chest to abdomen.

Indications for Vagus nerve stimulation

It is indicated as an added treatment for improving the symptoms of depression in patients who do not respond to following standard treatments.

  • Antidepressant medications
  • Psychological counselling (psychotherapy)
  • Electroconvulsive therapy (ECT)

Eligibility of vagus nerve stimulation

As per FDA guidelines, vagus nerve stimulation is performed in patients who satisfy below mentioned criteria.

  • Adults (age 18 or older)
  • Patients who have chronic and treatment-resistant depression
  • Patients who have not responded to antidepressant medications or electroconvulsive therapy (ECT)

Preparation for Vagus nerve stimulation

  • Your psychiatrist will perform complete physical examination before surgery.
  • You may be asked to conduct blood tests or other laboratory tests to ascertain that patient is medically fit for the procedure
  • Your doctor will prescribe antibiotics for preventing infection prior to the surgery
  • You should inform your doctor regarding any medications you are taking as you may be asked to stop or adjust the doses of certain medications before the surgery

Vagus Nerve Stimulation Procedure

During the vagus nerve stimulation, surgeon implants a device known as pulse generator in the chest of patient.  This pulse generator is connected to the left vagus nerve in patient’s neck through a wire threaded under the patient’s skin.

Doctors can monitor the activity of pulse generator and stimulates it to send out various electrical signals. These electrical signals are carried along the vagus nerve to the patient’s brain. It causes improvement in the symptoms of depression.

Risks of Vagus nerve stimulation

Although vagus nerve stimulation is a safe procedure, there are certain risks associated with surgery for implanting the device and during brain stimulation procedure.

Surgery risks

  • Pain at a point of incision
  • Infection
  • Heart problems
  • Incision scarring
  • Vocal cord paralysis
  • Breathing problems
  • Damage to the vagus nerve
  • Nausea

Side effects associated with vagus nerve stimulation

  • Chest pain
  • Cough
  • Throat pain
  • Voice changes
  • Breathing problems during exercise
  • Difficulty swallowing
  • Neck pain
  • Hoarseness
  • Prickling of the skin

Most of the side effects may improve over time, however certain side effects can be managed by adjusting the electrical impulses.

Other complications of vagus nerve stimulation

  • Pulse generator malfunction
  • Worsening of depression
  • Suicidal thoughts or behaviour

Results of Vagus nerve stimulation

  • In majority of the cases, depression symptoms will improve or diminish completely.
  • The optimal results are obtained after several months of treatment
  • Patient should continue to take antidepressant medication or attend psychotherapy sessions even after Vagus nerve stimulation.