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Vagus nerve stimulation for depression: efficacy and safety in a European study

Schlaepfer, T.E. ; Frick, C. ; Zobel, A. ; Maier, W. ; Heuser, I. ; Bajbouj, M. ; O'Keane, V. ; Corcoran, C. ; Adolfsson, R. ; Trimble, M. ; Rau, H. ; Hoff, H.-J ; Padberg, F. ; Müller-Siecheneder, F. ; Audenaert, K. ; Van den Abbeele, D. ; Matthews, K. ; Christmas, D. ; Stanga, Z. ; Hasdemir, M.

In: Psychological Medicine, 2008, vol. 38, no. 5, p. 651-661

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    Titre
    • Vagus nerve stimulation for depression: efficacy and safety in a European study
    Auteur
    • Schlaepfer, T.E.. Department of Psychiatry, University Hospital, Bern, Switzerland
    • Frick, C.. Department of Psychiatry, University Hospital, Bern, Switzerland
    • Zobel, A.. Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
    • Maier, W.. Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany
    • Heuser, I.. Psychiatrische Klinik der FU Berlin, Berlin, Germany
    • Bajbouj, M.. Psychiatrische Klinik der FU Berlin, Berlin, Germany
    • O'Keane, V.. Beaumont Hospital, Department of Psychiatry, Dublin, Ireland
    • Corcoran, C.. Beaumont Hospital, Department of Psychiatry, Dublin, Ireland
    • Adolfsson, R.. University Hospital Umea, Umea, Sweden
    • Trimble, M.. National Hospital for Neurology and Neurosurgery, Department of Neuropsychiatry and Neurology, London, UK
    • Rau, H.. Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
    • Hoff, H.-J. Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
    • Padberg, F.. Departments of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
    • Müller-Siecheneder, F.. Departments of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
    • Audenaert, K.. University Hospital Gent, Gent, Belgium
    • Van den Abbeele, D.. University Hospital Gent, Gent, Belgium
    • Matthews, K.. Ninewells Hospital and Medical School, Department of Psychiatry, Dundee, UK
    • Christmas, D.. Ninewells Hospital and Medical School, Department of Psychiatry, Dundee, UK
    • Stanga, Z.. Department of Psychiatry, University Hospital, Bern, Switzerland
    • Hasdemir, M.. Lindenhof Hospital, Department of Neurosurgery, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Psychological Medicine, 2008, vol. 38, no. 5, p. 651-661. Cambridge University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:289332
    Summary
    Background Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression. Method An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically. Results The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset; 44% of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63% at 3 months of stimulation) and coughing (23%). Conclusions VNS therapy was effective in reducing severity of depression; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study