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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression

Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression

Published on: January 7, 2019

Therapeutic armamentarium for treating depression.

Robert H Howland¹

¹University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. howlandrh@upmc.edu

Postgraduate Medicine

|August 3, 2010

Summary

Depression treatment involves numerous strategies, including medications and psychotherapy. For treatment resistance, options include switching or augmenting therapies, alongside alternative and neuromodulation treatments.

Area of Science:

Psychiatry and Mental Health
Clinical Medicine

Background:

Depressive disorders are a significant global health issue, contributing to disability, morbidity, and mortality.
A substantial number of cases remain undertreated or untreated, highlighting a critical unmet need.

Purpose of the Study:

To provide a comprehensive overview of available treatment strategies for depressive disorders.
To inform medical practitioners about the broad therapeutic options for depression management.

Main Methods:

Literature review of established and emerging treatments for depression.
Categorization of therapies into first-choice options, augmentation/switching strategies, nonstandard alternatives, and neuromodulation.

Main Results:

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Over 24 antidepressant medications and psychotherapies are first-line treatments.

Switching or adding therapies are key strategies for treatment resistance, with some combinations showing efficacy.

Nonstandard options include exercise, light therapy, sleep deprivation, and complementary therapies.

Neuromodulation therapies are available or under investigation for chronic and refractory depression.

Conclusions:

A wide array of treatment options exists for depressive disorders, ranging from pharmacotherapy and psychotherapy to novel interventions.
Effective management requires awareness of the full therapeutic armamentarium, especially for primary care practitioners.
Addressing undertreatment is crucial given the high prevalence and impact of depression worldwide.