Vagus Nerve Stimulation

What is Vagus Nerve Stimulation Therapy?

VNS Therapy is a device that stimulates the vagus nerve in your neck. The vagus nerve is connected to areas of the brain associated with controlling mood. VNS works by regularly sending mild pulses to the vagus nerve, which has been shown to improve depression symptoms. This is an ideal treatment for treatment resistant unipolar and bipolar depression.

VNS Therapy begins with a surgical procedure to implant a small pacemaker-like device in your chest. It is then attached to a stimulating wire that is threaded along your vagus nerve.

After the surgical implementation of the stimulation device, Dr. Giles can program the frequency and duration of electrical pulses to your vagus nerve, adjusting your ‘dose’ so to speak.

What is the vagus nerve?

Your vagus nerve is the longest cranial nerve; it runs from your brain to your large intestine. This nerve is the main nerve of your parasympathetic nervous system. Also known as the ‘rest and digest’ system, the parasympathetic nervous system is responsible for 

• Mood
• Digestion
• Heart rate, blood pressure, and respiration
• Immune system responses
• Mucus and saliva production
• Skin and muscle sensations
• Speech
• Taste
• Urine output

How does VNS Therapy work?

The implant procedure is outpatient surgery; it takes approximately 1 to 2 hours and is performed under general anesthesia at a hospital.

After the surgical implementation of the stimulation device, Dr. Giles can program the frequency and duration of electrical pulses to your vagus nerve in our office. The programming and delivery of electrical pulses are quick and painless. 

VNS Therapy is an adjunctive long-term treatment for treatment-resistant depression. Patients will be encouraged to maintain their usual treatments. In a 5-year study of 795 patients with TRD, results were superior with VNS Therapy plus traditional treatment compared to traditional treatment alone. 7 in 10 saw significant improvement with the addition of VNS Therapy.

Possible side effects from VNS Therapy include temporary hoarseness, cough, and shortness of breath. Most of these side effects only occur during the 30 seconds that the stimulator is on.

Why would I need to use VNS Therapy?

Dr. Giles might recommend VNS Therapy if you’ve been receiving treatment for major depressive disorder, but your depression hasn’t improved. Psychotherapy and antidepressant medication help many people recover from depression. However, experts believe that 30 - 40% of patients relying on psychotherapy and antidepressants don't experience relief from these treatments. VNS Therapy specifically addresses this type of treatment-resistant depression, and it is an ideal treatment for bipolar and unipolar depression. 

How Effective is VNS Therapy for TRD?

In a recent study, 7 in 10 patients saw significant improvement when VNS Therapy was added to their usual treatment. 4 in 10 patients fully or almost fully recovered from their depression symptoms when VNS Therapy was added to their usual treatment.

Frequently Asked Questions:

Is VNS Therapy covered by insurance? 

VNS Therapy is covered by many insurance plans, though it often takes 6 months for prior authorization approval, which is managed by the device manufacturer.

Where will device implantation take place?

Dr. Giles has relationships with well-trained surgeons and handles referrals and coordination of outpatient surgery in partnership with the device manufacturer. The surgery itself takes 1 - 2 hours and is performed under general anesthesia. Most patients will go home the same day. 

Will people be able to see the implanted device through my skin? 

The lead that travels under the skin is not visible. The neurostimulator is shaped like a disc and is roughly 2 inches in diameter (similar to a pacemaker). If you have a small frame or are very thin the device may be visible below your left collarbone.

Will I still need to take medication with VNS Therapy?

Yes. VNS Therapy is an add-on treatment. Most patients treated with VNS Therapy in past clinical studies also continued to take antidepressant medications.