4 ms·

Vagus Nerve Stimulation Improves Treatment-Resistant Depression Outcomes

51 points by laurex 9y ago

cpncrunch 9y ago
It's open label, so we have no idea how much is due to the placebo effect (which is always large in studies with novel treatments like this, especially for depression).
- deleted 9y ago
  [deleted]
- starpilot 9y ago
  Less significant for treatment-resistant depression, I imagine. They've been through this before and might have pretty dampened expectations.
BugsJustFindMe 9y ago
Vagus nerve stimulation, eh? As in the infamous cure for intractable hiccups[0]? I mean...of course that improves depression outcomes. How could it not? [0] - https://www.ncbi.nlm.nih.gov/pubmed/2299306 https://www.ncbi.nlm.nih.gov/pubmed/2299306
fao_ 9y ago
How exactly are they stimulating it?
- himom 9y ago
  Think pacemaker.
himom 9y ago
This is invasive (iVNS), which means installing a box in the patient’s chest and wrapping electrodes around the left VNS in the neck. :/ There have been studies on transcutaneous VNS (tcVNS) of the left ear as well. https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-12-255 https://bmccomplementalternmed.biomedcentral.com/articles/10...
MisterOctober 9y ago
I've anecdotally observed a trend of clinicians more centrally considering the role of nerves in psychological disorders. Like back in Bertie Wooster's day, when shrinks were called "nerve specialists" and many preparations marketed as mood enhancers referred to as "nervine tonics"
- perl4ever 8y ago
  The book "Memoirs of My Nervous Illness"[1] comes to mind. [1] https://www.goodreads.com/book/show/287490.Memoirs_of_My_Nervous_Illness https://www.goodreads.com/book/show/287490.Memoirs_of_My_Ner...
perl4ever 8y ago
I sincerely wish there was more research into how to measure depression in the first place. If you don't define the problem, you can't begin to search for a solution. My understanding is that we have nothing better to guide clinical studies than giving surveys asking how people feel. We need equivalents of finger-stick blood sugar tests and A1C tests for mental illness.
- your-nanny 8y ago
  I can always agree with "I wish there was more research" absent constraints and dependencies. But your post really seems to be saying that not nearly enough of the effort is being spent in this direction, and I'm wondering on what basis you think this? Because it is not true in my experience of dealing with depression researchers.
  - deleted 8y ago
    [deleted]
  - perl4ever 8y ago
    I donated to a research foundation, and I believe it was mainly spent on pointless experiments with rats. At the time, I didn't have a strong preference for what to fund, so I went with what was suggested to me. But at this point, I look back and see the most important thing they ever funded was some of the early development of optogenetics. So I'm coming to believe that basic tools and measurement should get most of the available funding. I think there's a lot of research directed at trying things at random that is just wasted. Any IT geek surely knows the difference between trying to debug something by flailing around with random theories and really buckling down and analyzing it. The latter seems slower, but it's the only way you make progress at all.
    - your-nanny 8y ago
      In other words, with only a casual acquaintence with the field and literature. Got it.
- s_m_t 8y ago

51 points by laurex 9y ago

It's open label, so we have no idea how much is due to the placebo effect (which is always large in studies with novel treatments like this, especially for depression).

deleted 9y ago
[deleted]
starpilot 9y ago
Less significant for treatment-resistant depression, I imagine. They've been through this before and might have pretty dampened expectations.

BugsJustFindMe 9y ago

Vagus nerve stimulation, eh? As in the infamous cure for intractable hiccups[0]? I mean...of course that improves depression outcomes. How could it not? [0] - https://www.ncbi.nlm.nih.gov/pubmed/2299306 https://www.ncbi.nlm.nih.gov/pubmed/2299306

fao_ 9y ago

How exactly are they stimulating it?

himom 9y ago
Think pacemaker.

himom 9y ago

This is invasive (iVNS), which means installing a box in the patient’s chest and wrapping electrodes around the left VNS in the neck. :/ There have been studies on transcutaneous VNS (tcVNS) of the left ear as well. https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-12-255 https://bmccomplementalternmed.biomedcentral.com/articles/10...

MisterOctober 9y ago

I've anecdotally observed a trend of clinicians more centrally considering the role of nerves in psychological disorders. Like back in Bertie Wooster's day, when shrinks were called "nerve specialists" and many preparations marketed as mood enhancers referred to as "nervine tonics"

perl4ever 8y ago
The book "Memoirs of My Nervous Illness"[1] comes to mind. [1] https://www.goodreads.com/book/show/287490.Memoirs_of_My_Nervous_Illness https://www.goodreads.com/book/show/287490.Memoirs_of_My_Ner...

perl4ever 8y ago

I sincerely wish there was more research into how to measure depression in the first place. If you don't define the problem, you can't begin to search for a solution. My understanding is that we have nothing better to guide clinical studies than giving surveys asking how people feel. We need equivalents of finger-stick blood sugar tests and A1C tests for mental illness.

your-nanny 8y ago
I can always agree with "I wish there was more research" absent constraints and dependencies. But your post really seems to be saying that not nearly enough of the effort is being spent in this direction, and I'm wondering on what basis you think this? Because it is not true in my experience of dealing with depression researchers.
- deleted 8y ago
  [deleted]
- perl4ever 8y ago
  I donated to a research foundation, and I believe it was mainly spent on pointless experiments with rats. At the time, I didn't have a strong preference for what to fund, so I went with what was suggested to me. But at this point, I look back and see the most important thing they ever funded was some of the early development of optogenetics. So I'm coming to believe that basic tools and measurement should get most of the available funding. I think there's a lot of research directed at trying things at random that is just wasted. Any IT geek surely knows the difference between trying to debug something by flailing around with random theories and really buckling down and analyzing it. The latter seems slower, but it's the only way you make progress at all.
  - your-nanny 8y ago
    In other words, with only a casual acquaintence with the field and literature. Got it.
s_m_t 8y ago