[Brain stimulation methods for resistance to therapy]

In psychiatry there is growing awareness of the urgent need for treatment of patients with severe depression who are refractory to treatment. While highly efficacious over its nearly 70-year history, electroconvulsive treatment is tainted with two basic disadvantages: high relapse quotas and sometimes extensive cognitive side effects. Therefore novel methods of brain stimulation are being employed: transcranial magnetic stimulation, magnetic seizure stimulation, vagus nerve stimulation, and deep brain stimulation. These four techniques are used in individual cases but still outside the framework of scientific research studies. Their clinical effects and effectivity require further definition. This paper reports the current status of brain stimulation methods and describes possible further developments.