About Treatment Resistant Depression

Although antidepressant medications help some people, many continue to experience depression in spite of treatment

Depression is one of the most commonly occurring and serious illnesses in the United States. About 1 in 6 American adults will experience a depressive episode at some point in their lives.1 Many times an episode of depression will respond to treatment, but often depression persists despite adequate treatment. As many as one third of people diagnosed with depression experience long periods of depression without improvement.1 Medications may relieve depression only partially, may not help, or may stop working after a while.

Treatment-resistant depression (TRD) occurs when 4 or more adequate antidepressant treatments have not provided desired improvement. If you have TRD, you are not alone. TRD may affect as many as 30% of people diagnosed with depression, or just over 4 million Americans.2,3

Psychiatrists have discovered that there are many different causes of depression, instead of one single cause. Itís not anybodyís fault. Although some depressions are more difficult to treat than others, psychiatrists will continue to try different treatments until he or she finds the right one. When depression is treatment resistant, psychiatrists often try treatments that target different chemicals within the brain, either by raising the levels of naturally occurring brain chemicals, called neurotransmitters, or by improving the ability of nerves to process signals. Psychiatrists are learning that many different neurotransmitters affect moods. Most antidepressant treatments may target or impact one or two potential causative factors of depression, but do not affect all the areas of the brain thought to affect mood. This may be one reason for treatment-resistant depression.1 Certain biologic factors can also contribute to treatment resistance, including genetics, changes within the brain over time or the body can change the way it handles a drug after a period of time.

People with TRD may require a different type of ongoing treatment for their depression. Depressions that are resistant to several treatments may respond to others. Donít give up hope! Treatment-resistant depression can be a long-lasting condition that interferes with daily activities and compromises quality of life.1,2 Therefore, long-term treatment is often recommended for treatment-resistant depression.1

If you experience treatment-resistant depression, you are not alone.

"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."

A. John Rush, MD, 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. Background and rationale for the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Psychiatr Clin North Am. 2003;26:457-494. 3. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617-627.

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The VNS Therapy System is indicated for use as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over 12 years of age with partial onset seizures, which are refractory to antiepileptic medications.

VNS Therapy (or the VNS Therapy System) is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.