Hope for treatment-resistant depression (TRD)

Hope for treatment-resistant depression (TRD) 24 Mar 2007 – MUSC Research Offers Hope For Those Resistant To
Depression Treatment
Researchers at the Medical University of South Carolina (MUSC) have
announced the results of a two-year study, which tested the
long-term antidepressant response to VNS (Vagus Nerve Stimulation)
Therapy™ in patients with treatment-resistant depression (TRD).

The study, of which Mark S. George, M.D., MUSC Distinguished
Professor of Psychiatry, Radiology and Neurosciences is a lead
author, will appear in the April 2007 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.

Patients included in this study, led by Harold A. Sackeim, PhD, of
Columbia University, experienced severe chronic depression which
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
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,” said George. “Patients with TRD
don’t respond to medications, and even when they do, they often
develop tolerance after 6 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 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 as 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 over 12 years of age 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.
Medical University of South Carolina

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