Vagus Nerve Stimulation (VNS) and Other Augmentation Strategies for Therapy-Resistant Depression (TRD): Review of the Evidence and Clinical Advice for Use

Helge H O Müller; Sebastian Moeller; Caroline Lücke; Alexandra P Lam; Niclas Braun; Alexandra Philipsen

doi:10.3389/fnins.2018.00239

Vagus Nerve Stimulation (VNS) and Other Augmentation Strategies for Therapy-Resistant Depression (TRD): Review of the Evidence and Clinical Advice for Use

Front Neurosci. 2018 Apr 10:12:239. doi: 10.3389/fnins.2018.00239. eCollection 2018.

Authors

Helge H O Müller¹, Sebastian Moeller², Caroline Lücke¹, Alexandra P Lam¹, Niclas Braun^{1

2}, Alexandra Philipsen¹

Affiliations

¹ Department of Psychiatry and Psychotherapy, Universitätsklinikum Bonn, Bonn, Germany.
² Department of Psychiatry and Psychotherapy, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.

Abstract

In addition to electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS) is one of the approved neurostimulation tools for treatment of major depression. VNS is particularly used in therapy-resistant depression (TRD) and exhibits antidepressive and augmentative effects. In long-term treatment, up to two-thirds of patients respond. This mini-review provides a comprehensive overview of augmentation pharmacotherapy and neurostimulation-based treatment strategies, with a special focus on VNS in TRD, and provides practical clinical advice for how to select TRD patients for add-on neurostimulation treatment strategies.

Keywords: affective disorders; clinical practice; neurostimulation; therapy-resistant depression; vagus nerve stimulation.

Publication types

Review