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Updated: Jul 11, 2025

Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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[Vagus Nerve Stimulation (VNS) in Depression].

Erhan Kavakbasi1, Bernhard T Baune1

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Vagus nerve stimulation (VNS) offers a safe, long-term treatment for severe depression, improving quality of life and cognitive function. This adjunctive therapy shows significant response rates over time for treatment-resistant depression.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Devices

Background:

  • Major depressive disorder affects many, with a significant portion experiencing chronic, treatment-resistant symptoms.
  • Vagus nerve stimulation (VNS) is an established adjunctive therapy for treatment-resistant depression, CE-certified in the EU since 2001.

Purpose of the Study:

  • To provide an overview of vagus nerve stimulation (VNS) as a treatment for depression.
  • To focus on clinically relevant aspects of VNS for patients with depression.

Main Methods:

  • A narrative literature review was conducted.
  • The review focused on the indication, implantation procedure, stimulation parameters, side effects, and long-term outcomes of VNS in depression.

Main Results:

  • VNS involves surgical implantation of a pulse generator stimulating the vagal nerve.
  • The most common side effect is hoarseness, with antidepressant effects emerging over 6-12 months.
  • A large registry showed a cumulative response rate of 67.6% at 5 years for VNS plus treatment-as-usual (TAU) versus 40.9% for TAU alone.

Conclusions:

  • Vagus nerve stimulation (VNS) is a safe, long-term treatment option for severely affected patients with depression.
  • VNS positively impacts depression severity, quality of life, and cognitive function.
  • Potential mechanisms include increased monoaminergic transmission and anti-inflammatory effects.