Vagus Nerve Stimulation – Indications, Eligibility, Preparation, Procedure, Risks

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.