Introducing VNS Therapy
VNS Therapy Mechanism of Action
Dosing Strategies
Safety & Tolerability
Patient Quality of Life
Patient Management

Treatment-resistant depression is a chronic illness requiring lifelong management1
The percentage of patients treated for depression who get well and stay well may be as low as 35%.2 Of patients with a major depressive disorder (MDD), 20% to 35% experience a chronic, unremitting course.2 After 1 or 2 prior episodes of depression, patients have a 50% to 90% risk of relapse.3 Unfortunately, current treatments for depression, including electroconvulsive therapy (ECT), have substantial relapse rates following acute response, remission and recovery.4,5 And these subsequent episodes are often of longer duration, more severe, and less responsive to treatment.3

STAR*D: Long term outcomes of standard treatment strategies
The landmark Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, sponsored by the National Institute of Mental Health, found that remission rates declined as the number of treatments increased. The calculated cumulative remission rate after 4 acute treatment trials was 67%. Importantly, however, patients who required more treatment steps had higher relapse rates during a 12-month naturalistic follow-up phase. Intolerance rates also increased with each treatment step.6 

Now, VNS Therapy gives you a new strategy for your patients with TRD
VNS Therapy is different from other treatments for depression. With a unique mechanism of action, it provides efficacy that improves over time and is sustained long term.6,7 Patients also experience quality-of-life benefits that improve over time.8 Unlike many other treatments for depression, VNS Therapy provides assured adherence and high continuation rates, as well as an impressive safety and tolerability profile , with side effects that typically decrease over time.7

Clinical studies show that VNS Therapy may succeed where other treatments have failed

Hear from a physician
"When I think about VNS Therapy I think about the long-term management of depression. This is a treatment whose benefit appears to increase over time and that makes it different than the other treatments that we have available. Those individuals who have not been able to achieve a long-term benefit with current treatments are good candidates for VNS."

—Dr. A. John Rush, Vice Chair, Department of Clinical Sciences Professor, Department of Psychiatry University of Texas Southwestern Medical Center at Dallas

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1. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. April 2000;157(suppl):1-45.
2. Fava M, Rush AJ, Trivedi MH, et al for the STAR*D Investigators Group. Background and rationale for the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Psychiatr Clin N Am. 2003;26:457-494.
3. Zajecka JM. Clinical issues in long-term treatment with antidepressants. J Clin Psychiatry. 2000;61(suppl 2):20-25.
4. Amsterdam JD, Greden JF, Nierenberg AA, Thase ME. Treatment-resistant depression. J Clin Psychiatry Intercom. August 2000.
5. Sackeim HA, Haskett RF, Mulsant BH, et al. Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. JAMA. 2001;285:1299-1307.
6. Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163:1905-1917.
7. George MS, Nahas Z Bohning D, et al. Vagus nerve stimulation: a new form of therapeutic brain stimulation. CNS Spectrums. 2000;5:2-11.
8. Physician's Manual. VNS TherapyTM Pulse Model 102 Generator and VNS TherapyTM Pulse Duo Model Generator. Houston, Tex: Cyberonics, Inc; 2006.

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