VNS Therapy and Electroconvulsive Therapy (ECT)

VNS Therapy has been shown to succeed in people who have had ECT

VNS Therapy has been shown to succeed in people who have had ECT. Of the 205 people evaluated in a major clinical study of VNS Therapy for TRD, 64 people had received ECT during their current depression, and 97 had received it at some time in their lives.  About 1 in 3 of these people experienced significant mood improvement with VNS Therapy. This was the same as for people who had not had ECT during their current depression. People who had received ECT before having VNS Therapy were just as likely to experience improvement as those who had not had ECT.¹

ECT remains one of the most effective short-term treatments for severe depression. Of people with severe depression, many may experience improvement quickly with ECT.  Repeated treatments are necessary to achieve the most complete antidepressant response. Initially, ECT usually involves 3 sessions per week for several weeks.² However, people often become depressed again after the treatments are stopped. Less than half of people in one study stayed well for a year.³ Many people require repeat treatments, some as often as once a month, to stay well.²

VNS Therapy is a long-term treatment. Most people who responded to VNS Therapy maintained their improvement long term.⁴  After the pulse generator is activated and the dose of stimulation is adjusted, stimulation is regular and automatic. Some patients experience benefits from VNS Therapy within a few weeks. Many see benefits over several months.⁴ 

VNS Therapy is compatible with ECT. ECT does not interfere with VNS Therapy. A person who has VNS Therapy can have ECT later, if necessary. The VNS Therapy pulse generator must be turned off during the ECT procedure but can be restarted afterwards.  If you have treatment-resistant depression, your psychiatrist may recommend either treatment, or the 2 treatments may be used together.

References:
1. Data on File. Cyberonics, Inc. Houston, Tex.  2. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. April 2000;157(suppl):1-45. 5. 3. 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.  4. Rush AJ, Sackeim HA, Marangell LB, et al. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study. Biol Psychiatry. 2005;58:355-363.