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Abstract
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AIM: The purpose of this study was to evaluate the efficacy of vagus nerve stimulation (VNS) as a therapeutic option for treatment-resistant depression (TRD), with follow-up periods of 1, 3 and 5 years after VNS surgery.
METHODS: We examined 27 consecutive patients with unipolar TRD. Depressive symptoms were evaluated both at baseline and at follow-up after the surgery by means of the 21-item Hamilton Rating Scale for Depression (HAM-D 21).
RESULTS: The mean HAM-D preoperative score was 25.6. Twenty-two patients were evaluated after 1 year of treatment, and the mean improvement of the HAM-D score was of 10.3. Five patients (20%) went into complete remission (HAM-D < 7) after 1 year, six patients (22.3%) were considered responders (50% reduction of HAM-D scoring) and eight patients had score reduction of less then 20%. Nineteen patients were evaluated after 24-36 months: the average improvement on the HAM-D score was of 12.1 points (47.2%). One patient went into complete remission and eight patients (42.1%) were responders. Up to the present date, seven patients have undergone re-evaluation at 48-60 months from surgery showing an average score reduction of 14.2. Two more patients obtained complete remission, while four of them did not have any improvement since their last follow-up control visit.
CONCLUSION: VNS antidepressant was successful in 20% of TRD patients, although some patients required several months to obtain clinical improvement or remission of symptomatology. Nonetheless this procedure can be considered as a useful option in treating TRD.
Language: en |