Psycho-Babble Medication Thread 13468

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

Vagus Nerve Stimulation

Posted by Janice on October 19, 1999, at 22:25:20

Hi everyone,

I was in Hawaii last week and happened to stumble upon this article about using vagus nerve stimulation to treat untreatable depression. It definately seems like a completely new approach to me. I will retype parts of the article for you, as I don't have a scanner.

Stimulating a nerve that runs from the neck into one of the brain's most mysterious regions appears promising enough at relieving once-untreatable depression that the government just granted permission for a study at 15 hospitals around the country. The treatment, called vagus nerve stimulation, involves sending tiny electric shocks into the vagus nerve in the neck, where it then relays messages deep into the brain. About half of the 30 depressed patients treated in a pilot study - people who had failed every other treatment - "got a very good response"...The stimulator is essentially a brain pacemaker. A generator the size of a pocket watch is implanted into the chest. Wires snake up the neck to zap the nerve every few minutes. Two years ago, the Food and Drug Administration approved the implant to treat severe epilepsy, a way to signal the brain to reduce seizures...doctors began reporting the epilepsy patients felt happier even if the implant failed to reduce their seizures.

It's also seems to be good for enhancing memory and controlling appetites of obese people.

Interesting, yes? I'm not certain as to whether you can locate this article through the internet, but it was on page A14, Tuesday, October 12 in the Star Bulletin, Honolulu, Hawaii. Janice

 

Re: Vagus Nerve Stimulation

Posted by dj on October 19, 1999, at 23:40:09

In reply to Vagus Nerve Stimulation, posted by Janice on October 19, 1999, at 22:25:20

Sounds interesting! Do you have to be obese for it to enhance your memory. ; )

> It's also seems to be good for enhancing memory and controlling appetites of obese people.
>

 

Re: Vagus Nerve -- on a more serious note

Posted by dj on October 20, 1999, at 1:01:36

In reply to Vagus Nerve Stimulation, posted by Janice on October 19, 1999, at 22:25:20

Some excerpts from a New Yawk Times article:

July 27, 1999

Some Still Despair in a Prozac Nation

"...Like many people who suffer from depression, Ms. McGann, who is 37, has heard the public service announcements that proclaim her condition to be eminently treatable. She has seen the advertisements for Prozac and Zoloft and Luvox and a dozen other antidepressant drugs, old and new, promotions that show smiling men and women happily going about their lives. She can cite the studies showing that certain types of psychotherapy are effective for depression, especially when combined with antidepressants.

Ms. McGann's own experience, however, has been slightly different: In the five years since she her latest battle with the illness began, she has tried virtually every treatment the mental health field has to offer -- and not one of them has worked. Not drugs, either singly or in combination, not psychotherapy, not the electroshock therapy she received in 1995.

Recently, she had a device implanted under her collarbone that delivers electrical stimulation to the vagus nerve in her neck -- a procedure that has proved effective for some forms of severe epilepsy, and that Columbia University researchers are trying on an experimental basis in depression. But so far that treatment, too, appears to be failing. As a last resort, she said, she may decide to undergo a cingulotomy, a form of brain surgery in which fibers deep in the frontal lobe are severed...

Treatment-resistant depression is a continuum," said Dr. Harold Sackheim, chief of biological psychiatry at the New York State Psychiatric Institute. "Some people don't do that well with first treatment, but they respond to the second. Some will go 20 years and nothing helps them."

In the most dire and intractable cases, some physicians turn to experimental approaches like vagus nerve stimulation, which Dr. Sackheim's institute is studying as a treatment for refractory depression, or even cingulotomy, which has been found to help some people for whom nothing else works.

Researchers know little about why some people respond fully to antidepressant treatment and others do not. In some cases, the difference may lie in brain structure or brain chemistry: different people respond differently to any type of drug.

But some patients who are deemed refractory may also simply have received inadequate treatment, taken a drug at a dosage too low to be effective or discontinued the medication before the four to six consecutive weeks most experts consider a reasonable trial.

Complicating things further, many patients who do not respond to antidepressant treatment are not just depressed, but have other difficulties as well: medical or neurological conditions, for example, or other psychiatric problems like substance abuse, panic attacks or personality disorders. "The frustration," Dr. Kupfer said, "is that there are a number of different factors where the final common denominator is that people are not feeling better."

And while experts agree that most types of severe or recurrent depression have their roots in biology, psychology plays a role as well.

Dr. Judith Nowak, a psychopharmacologist and psychoanalyst in Washington, said that, in her experience, some people who did not respond to antidepressants or combinations of drugs had complicated life problems that could "only be understood, managed and corrected through psychological intervention."

"I've seen several people who had lifelong refractory depression and got caught in a loop of many experimental medication regimens," Dr. Nowak said, "But it really was through good psychotherapy that they were helped." ...

 

Re: Vagus Nerve Stimulation

Posted by Bob on October 20, 1999, at 11:55:21

In reply to Vagus Nerve Stimulation, posted by Janice on October 19, 1999, at 22:25:20

The Star-Bulletin has a pretty nice web site ... well, as long as it remains in business (another Gannett paper being forced down the drain).

They didn't have the article you mentioned, Janice, but they had an earlier article on the pacemaker's use in epilepsy, for those interested.

http://starbulletin.com/1999/06/07/news/story4.html

Bob

 

Re: Vagus Nerve Stimulation

Posted by Annie on October 20, 1999, at 13:59:09

In reply to Vagus Nerve Stimulation, posted by Janice on October 19, 1999, at 22:25:20

Here is the address of Cybertronics, who makes the Vagal Nerve Stimulator http://www.cyberonics.com/
They have a message board with a lot of discussion about it's use for depression.

Also here is an exerpt of an article that was emailed to me. Those of you interested in TMS and rTMS will recognize Dr. Mark George.

I believe this Article was dated October 11.
Annie


Brain Shocks May Help Depression

.c The Associated Press

By LAURAN NEERGAARD

WASHINGTON (AP) - The former shipbuilder had severe depression unrelieved by any of today's therapies, so sick he had trouble even leaving his house. Then doctors implanted a pacemaker-like device to stimulate a part of his brain thought important for mood - and that very day the man laughed.

``It was remarkable,'' recalled Dr. Mark George of the Medical University of South Carolina, who performed the experimental implant. ``I said, 'Are you being forced to laugh or do you feel good inside?' He said both.''

Stimulating a nerve that runs from the neck into one of the brain's most mysterious regions appears promising enough at relieving once-untreatable depression that the government just granted permission for a study at 15 hospitals around the country.

The treatment, called vagus nerve stimulation, involves sending tiny electric shocks into the vagus nerve in the neck, where it then relays messages deep into the brain.

About half of the 30 depressed patients treated in a pilot study - people who had failed every other treatment - ``got a very good response,'' George said in an interview.

The results are not definitive, he cautioned. But he added, ``Stimulating there really is a wonderful portal into the base of the brain.''

Indeed, scientists think stimulating this nerve could have even more far-reaching effects, such as enhancing memory or treating obesity by curbing appetite.

That's because the vagus nerve is what Dr. Mitchell Roslin of Brooklyn's Maimonedes Medical Center calls ``one of the information superhighways'' between the brain and other organs. It relays messages, such as signals to regulate heartbeat, and sends messages back to the brain, such as when the stomach is full.

The nerve also reaches deep into brain regions thought to regulate mood and emotion, said Dr. John Rush of the University of Texas Southwestern Medical Center, who heads the pilot depression study.

If the implant truly signals the depressed brain circuits to act more normally, it could prove important for some of the estimated 1 million Americans with depression uneased by conventional therapy.

The stimulator is essentially a brain pacemaker. A generator the size of a pocket watch is implanted into the chest. Wires snake up the neck to zap the nerve every few minutes.

Two years ago, the Food and Drug Administration approved the implant to treat severe epilepsy, a way to signal the brain to reduce seizures.

Depression often accompanies epilepsy. Soon after the implants began selling, doctors began reporting epilepsy patients who felt happier even if the implant failed to reduce their seizures.

``There's certainly an overlap between emotions and the site where people have intractable seizures,'' said Dr. Cynthia Harden of Cornell University, author of one of those early studies.

So manufacturer Cyberonics Inc. funded a pilot study of patients with untreatable depression not complicated by epilepsy. Full results won't be unveiled until December, but George said about half the patients responded well - prompting the FDA last week to approve a new study, beginning early next year at 15 hospitals, to prove the effect.

T


> Hi everyone,
>
> I was in Hawaii last week and happened to stumble upon this article about using vagus nerve stimulation to treat untreatable depression. It definately seems like a completely new approach to me. I will retype parts of the article for you, as I don't have a scanner.
>
> Stimulating a nerve that runs from the neck into one of the brain's most mysterious regions appears promising enough at relieving once-untreatable depression that the government just granted permission for a study at 15 hospitals around the country. The treatment, called vagus nerve stimulation, involves sending tiny electric shocks into the vagus nerve in the neck, where it then relays messages deep into the brain. About half of the 30 depressed patients treated in a pilot study - people who had failed every other treatment - "got a very good response"...The stimulator is essentially a brain pacemaker. A generator the size of a pocket watch is implanted into the chest. Wires snake up the neck to zap the nerve every few minutes. Two years ago, the Food and Drug Administration approved the implant to treat severe epilepsy, a way to signal the brain to reduce seizures...doctors began reporting the epilepsy patients felt happier even if the implant failed to reduce their seizures.
>
> It's also seems to be good for enhancing memory and controlling appetites of obese people.
>
> Interesting, yes? I'm not certain as to whether you can locate this article through the internet, but it was on page A14, Tuesday, October 12 in the Star Bulletin, Honolulu, Hawaii. Janice
>

 

to Bob re: Gannett

Posted by allison on October 20, 1999, at 17:23:41

In reply to Re: Vagus Nerve Stimulation, posted by Bob on October 20, 1999, at 11:55:21

> The Star-Bulletin has a pretty nice web site ... well, as long as it remains in business (another Gannett paper being forced down the drain).

Oooh! Gannett sarcasm! I'm all for that! Are/were you a Gannettoid, or just a conscientious objector?
allison

 

Re: Vagus Nerve Stimulation

Posted by Noa on October 20, 1999, at 19:41:14

In reply to Re: Vagus Nerve Stimulation, posted by Annie on October 20, 1999, at 13:59:09

Anyone know anything about negative effects? Risks? It sounds great, makes me want to sign up now. Can people go off meds with this zapgadget?

 

Re: Vagus Nerve Stimulation

Posted by dj on October 20, 1999, at 22:18:04

In reply to Re: Vagus Nerve Stimulation, posted by Noa on October 20, 1999, at 19:41:14

Well looking at the bulletin board where people post comments at the product website I came across the following which would give me pause for contemplation:

" 10/12/99 1:53:46 PM
I had my VNS fitted on the 7th of September and activated on the 24th. I have had mild pain and itching since the operation however for 2 days now the pain has become unbearable. I can only describe it as a tearing pain. I also feel I'm am falling into depression and getting agressive with my husband. I have now got an appointment with my GP although he'll probably refer me back to the hospital and not want to get involved. I have an appointment with the hospital on Friday although that is to increment the VNS.
Has anyone had any similar experiences? Did it last? What did you or the doctors do about it? I would be very greatful if you could reply quickly."

http://www.cyberonics.com/bbs/treplies.asp?message=29&all=True

Despite this there is a guy named Herb who posts in a depression thread, whose wife will be undergoing surgery for this device on November 15 if she is is accepted. He is going to be keeping that board posted on his wife's progress and I've requested that he consider doing the same for PB.

> Anyone know anything about negative effects? Risks? It sounds great, makes me want to sign up now. Can people go off meds with this zapgadget?

 

dj, how can you be so depressing about depression?

Posted by Janice on October 20, 1999, at 22:35:45

In reply to Re: Vagus Nerve Stimulation, posted by dj on October 20, 1999, at 22:18:04

Generally speaking, it's the people who therapies and medications have fail that come to these bulletin boards to post about their problems. Janice. You're terribly quick to look for problems.

Sorry I didn't call you when I was in Vancouver; I didn't get near a computer in Hawaii, plus when I was in Vancouver, it was the middle of the night for me. Janice.

 

Pays to know the downside as well as the upside, J

Posted by dj on October 20, 1999, at 23:03:51

In reply to dj, how can you be so depressing about depression?, posted by Janice on October 20, 1999, at 22:35:45

Sometimes I am, sometimes I'm not, depends how depressed I am : 0 .If you read to the end of that post I believe I noted that I requested that someone who's wife may be getting treatment keep the babble community apprised of her progress. And Noa had inquired whether or not anyone knew of any downsides...

For those who have acess to CBC-Radio there is a 5 part series on in the mornings (don't know the time -- between 8 & 12) and repeated at 8 p.m. in the evenings called Depths of Despair. It's a very good series of half hour discussions on different aspects of depression. Tonight was drugs, yesterday diagnosis, tomorrow is EST and I suspect Friday p.m. will be alternative approachs.

So J. r u back in T.O., P.E.I., Calgary or are you someplace altogether different these days, sporting your tan!

>You're terribly quick to look for problems.


 

Re: Vagus Nerve Stimulation

Posted by Eric on October 21, 1999, at 0:00:51

In reply to Vagus Nerve Stimulation, posted by Janice on October 19, 1999, at 22:25:20

I know the guy who started the VNS program for refractory depression. Dr. Mark George at MUSC in Charleston, SC is a neuropsychiatrist and radiologist there. I met him and he even physically did my rTMS therapy this past summer. He is in charge of the rTMS program at MUSC as well as the VNS program. In fact, they did the first VNS implant for refractory depression at MUSC. This guy is also doing a lot of research in developing the ability to image and map the brain using functional MRI scans, PET scans, SPECT scans, etc. It is very, very technical but this guy along with other neuroscientists are trying to develop the capability to take an image of a mentally ill person and diagnose them via imaging. I guess this might eventually replace old fashioned psychiatric interview type diagnostic methods. I am all for these new, more modern diagnostic methods they are trying to develop. Basically, what this guy is doing I think is melding neurological and radiological tools and knowledge with psychiatry to develop new ways of treatment and diagnosing mental illness.

I was told the VNS program is for "truly refractory" patients. Sounds to me VNS is for people who have failed ECT, MAOIs, rTMS, etc.

My experience with rTMS is the results are transint because a two week session is not enough. Perhaps if they perfected it and it was approved by the FDA, etc. and you could get rTMS treatment daily for several months straight I believe it might work great and "flick the switch." But my experience was two weeks of treatment was too short for a sustained effect. Basically, my impression of it was if you could get more of it over a sustained period it might really work.

Dr. George is one smart dude. MUSC at Charleston is a beautiful, peaceful place to get rTMS treatment by the way. I got rTMS treatment by day and then went to the beach for a few hours at nearby Folly beach. So it was like I was getting rTMS treatment PLUS natural light therapy at the same time LOL.

 

Re: Vagus Nerve Stimulation

Posted by Eric on October 21, 1999, at 0:04:38

In reply to Re: Vagus Nerve Stimulation, posted by Eric on October 21, 1999, at 0:00:51

Oh yeah, I forgot to add. This guy Dr. George is board certified in BOTH psychiatry and neurology. Plus on top of that he is a radiologist! Talk about being a multiskilled doctor. So, he can use radiological methods(MRI, PET, SPECT) to image the brain for mental illness research. Plus use neurology methods and try to combine them with psychiatry. VNS came out of epilepsy treatment and epilsepsy is the purview of neurologists, not psychiatrists. We need more of this sort of thing.

 

Re: to Allison re: Gannett

Posted by Bob on October 21, 1999, at 0:21:54

In reply to to Bob re: Gannett, posted by allison on October 20, 1999, at 17:23:41

> Oooh! Gannett sarcasm! I'm all for that! Are/were you a Gannettoid, or just a conscientious objector?
> allison

Nothing conscientious about my objections! Bastages! I was raised blue-collar, pro-Union, liberal Democrat -- Gannett makes me spittin' mad.

grrrrrrrrrrrrrr
Bob

 

to Bob re: Gannett

Posted by allison on October 21, 1999, at 7:54:51

In reply to Re: to Allison re: Gannett, posted by Bob on October 21, 1999, at 0:21:54

Gannett makes me spittin' mad.
>
> grrrrrrrrrrrrrr

I'm with ya. I worked for them as a middle manager for 9 years, ten months, 9 days. Still thanking my lucky stars to be out of that ungrateful, arrogant, two-faced, political, Corporate Cuisinart.

grrrrrrr-squared!


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