A One-Year Comparison of Vagus Nerve Stimulation with Treatment as Usual for Treatment-Resistant Depression

George, Mark S.; Rush, A. John; Marangell, Lauren B.; Sackeïm, Harold A.; Brannan, Stephen K.; Davis, Sonia M.; Howland, Robert H; Kling, Mitchel A.; Moreno, Francisco; Rittberg, Barry R.; Dünner, David L.; Thomas, Sonia; Carpenter, Linda L.; Burke, Michael J.; Ninan, Philip T.; Goodnick, Paul J.

doi:10.1016/j.biopsych.2005.07.028

Cited by 307 publications

(128 citation statements)

References 20 publications

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“…This analysis showed a significantly higher IDS-SR response rate after 12 months than in a control group drawn from a separate study of patients with treatment-resistant depression who received usual care without VNS (17.0% vs 7.3%; p ϭ 0.032). 81 While the failure to use any randomization method in the long-term continuation study and the use of a separate naturalistic study to provide a control group provoked much controversy, many contend that the depression remission rates achieved with VNS are compelling. Common adverse effects included voice alteration, hoarseness, cough, shortness of breath, dysphagia, and neck pain.…”

Section: Vagus Nerve Stimulationmentioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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Section: Vagus Nerve Stimulationmentioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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“…125 Evidence exists for modest efficacy at long-term (12 months) follow-up. 126,127 In recent years, chronic deep brain stimulation (DBS) in pathologically overactive neural circuits has been found to produce significant therapeutic benefits in those who suffer from Parkinson's disease. 128,129 In a preliminary and uncontrolled yet intriguing experiment, Mayberg et al 130 applied high-frequency DBS to the subgenual cingulate (BA25) of six subjects with severely treatment-refractory depression.…”

Section: Presumptive Mood Disorder Circuitsmentioning

confidence: 99%

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Carlson¹,

Singh²,

Zarate³

et al. 2006

NeuroRX

132

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Summary:Major depressive disorder and bipolar disorder are severe mood disorders that affect the lives and functioning of millions each year. The majority of previous neurobiological research and standard pharmacotherapy regimens have approached these illnesses as purely neurochemical disorders, with particular focus on the monoaminergic neurotransmitter systems. Not altogether surprisingly, these treatments are inadequate for many individuals afflicted with these devastating illnesses. Recent advances in functional brain imaging have identified critical neural circuits involving the amygdala and other limbic structures, prefrontal cortical regions, thalamus, and basal ganglia that modulate emotional behavior and are disturbed in primary and secondary mood disorders. Growing evidence suggests that mechanisms of neural plasticity and cellular resilience, including impairments of neurotrophic signaling cascades as well as altered glutamatergic and glucocorticoid signaling, underlie the dysregulation in these circuits. The increasing ability to monitor and modulate activity in these circuits is beginning to yield greater insight into the neurobiological basis of mood disorders. Modulation of dysregulated activity in these affective circuits via pharmacological agents that enhance neuronal resilience and plasticity, and possibly via emerging nonpharmacologic, circuitry-based modalities (for example, deep brain stimulation, magnetic stimulation, or vagus nerve stimulation) offers promising targets for novel experimental therapeutics in the treatment of mood disorders.

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“…For instance, cognitive therapy may be useful in reducing relapses, once the treatment is stopped (Fava et al, 1998Hollon et al, 2005) yet it is more time consuming and expensive in the short term. So, too, vagus nerve stimulation (Rush et al, 2005a, b;Sackeim et al, 2001;George et al, 2005) may have only modest or minimal shortterm effects, yet in the longer-term, efficacy may increase. The fact that one should incorporate the effects of future treatment decisions when evaluating present treatment is well known to scientists who work on improving sequential decision making (Parmigiani, 2002; see comments on myopic decisions in Sutton and Barto (1998)).…”

Section: Constructing Decision Rules From Datamentioning

confidence: 99%

Methodological Challenges in Constructing Effective Treatment Sequences for Chronic Psychiatric Disorders

Murphy

Oslin

Rush

et al. 2006

Neuropsychopharmacol

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Psychiatric disorders are often chronic conditions that require sequential decision making to achieve the best clinical outcomes. Sequential decisions are necessary to accommodate treatment response heterogeneity, a variable course of illness, and the often heavy burden associated with intensive or longer-term treatment. Yet, only a few studies in this field have been designed to address sequential decisions. Most of the experimental designs and data analytic methods that are best suited for improving sequential clinical decision making are often found in nonmedical fields such as engineering, computer science, and statistics. Promising designs and methods are surveyed with a focus on those areas most immediately useful for informing clinical decision making.

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A One-Year Comparison of Vagus Nerve Stimulation with Treatment as Usual for Treatment-Resistant Depression

Cited by 307 publications

References 20 publications

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Methodological Challenges in Constructing Effective Treatment Sequences for Chronic Psychiatric Disorders

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