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Research lends hope for those resistant to depression treatment by Tim Gehret Public Relations Researchers at MUSC and Columbia University Medical Center concluded a two-year study that tested the long-term antidepressant response to VNS (Vagus Nerve Stimulation) Therapy in patients with treatment-resistant depression (TRD).   Results of the study, authored by Mark S. George, M.D., MUSC Distinguished Professor of Psychiatry, Radiology and Neurosciences, will appear in the April  issue of the International Journal of Neuropsychopharmacology.   Results showed that of the patients who responded to VNS Therapy, either early or later in treatment, the majority continued to experience significant clinical benefit for up to 24 months. VNS Therapy is the first and only treatment for TRD to demonstrate such long-term improvements.   The study was led by Harold A. Sackeim, Ph.D., professor of psychiatry and radiology at Columbia University. Patients included in this study experienced severe chronic depression that proved to be treatment-resistant. The study participants had a 50-percent improvement in their depressive symptoms at either three months or a year after being treated with VNS therapy. Between 61 percent and 79 percent of patients sustained this response for 24 months. The durability of response was not attributable to alterations in other treatments.   “These data showing durability of response with VNS therapy are pretty remarkable under any circumstances, but particularly for the patient population studied here,” George said. “Patients with TRD don’t respond to medications, and even when they do, they often develop tolerance after six months, and the depression returns. These findings regarding long-term sustained effectiveness are very encouraging for psychiatrists and patients with treatment-resistant depression. This study analysis provides additional confirmation that, at least for some patients, the benefits of VNS therapy for TRD are long-term and improve over time.”   Many people with major depression relapse frequently, often despite numerous other treatment trials. More than 40 percent of patients experience a recurrence after two years, and more than 60 percent experience recurrence after five years. Eighty percent to 90 percent of those patients having experienced two or more episodes of depression will have additional episodes. Electroconvulsive therapy (ECT) is considered by many psychiatrists to be the most effective acute intervention for TRD. However, the majority of TRD patients relapse during the first year following response to ECT. This study shows that VNS Therapy is an effective long-term treatment option for some of these patients.   The FDA approved VNS therapy as an adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments. VNS therapy is also FDA-approved as an adjunctive therapy used to reduce the frequency of seizures in adults and adolescents older than 12 years with partial onset seizures that are refractory to antiepileptic medications. In addition to treatment-resistant depression and pharmacoresistant epilepsy indications, VNS Therapy is at various stages of research as potential treatments for anxiety disorders, Alzheimer’s disease, bulimia, chronic headache/migraine and morbid obesity.     Friday, April 6, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.