Vagal nerve stimulation, an innovative therapy for depression

The Saint Louis University Health Sciences Center medical team involved in the research and development of an innovative therapy for depression - vagal nerve stimulation (VNS) - is starting a new clinic for patients who have treatment-resistant depression.

The vagal nerve stimulator was approved Friday by the Food and Drug Administration for treatment-resistant depression following clinical trials around the United States, including Saint Louis University.

“This important service could dramatically improve the quality of life for some of the sickest patients, patients who had been on seven to 10 medications and continued to be depressed for years,” says Dr. Charles Conway, who researched vagal nerve stimulation and now will lead the Saint Louis University Vagal Nerve Stimulation Clinic.

The small device is implanted in front of the armpit and has leads that run under the skin to the vagal nerve in the neck. It has been used for and is FDA-approved to treat epilepsy as well.

Charles Donovan, who had participated in the clinical research at Saint Louis University and written a book about his experience, says vagal nerve stimulation changed his life.

“I feel giddy that I’ve gone from the depths of despair to a normal life,” he says. “For over 20 years I had tried every available treatment to give me some relief from the unbearable suffering I experienced from chronic depression.

“When I was implanted with the vagus nerve stimulator in April of 2001, I was desperate. I didn’t want to continue to live a life of utter despair. I had absolutely no idea that my life was about to be completely changed.”

Conway was the principal investigator at the Saint Louis University study site, one of 20 sites across the country to participate in a 200-patient clinical trial between 2000 and 2003.

“One of the most rewarding things I’ve done as a psychiatrist is to conduct research that shows we can help people who have lived essentially all of their lives with severe depression get better,” says Conway, an assistant professor of psychiatry at Saint Louis University School of Medicine and a SLUCare psychiatrist. “Dr. George Grossberg, who directs our division of geriatric psychiatry, and I have found the treatment is successful in helping numerous patients who have failed all other existing therapies.

“Now, with a new treatment option on the horizon, I am excited we will reach more patients through the Saint Louis University Vagal Nerve Stimulation Clinic. These are patients who had given up hope of ever feeling better.”

Richard Bucholz, M.D., director of the division of neurosurgery at Saint Louis University, brings his experience surgically implanting the device during the study to SLU’s Vagal Nerve Stimulation Clinic. He also was involved in studies that led to the FDA’s approval of vagal nerve stimulation to treat epilepsy.

Patients who are interested in the service will receive an initial consultation to see if the treatment is appropriate; a surgical consultation if they are eligible; and follow-up appointments to monitor and adjust the device settings.