Comparison to Other Depression Therapies

COMPARISON TABLE OF DEPRESSION THERAPIES
PHARMACOTHERAPY
ELECTROCONVULSIVE THERAPY (ECT)
VAGUS NERVE STIMULATOR (VNS)

Vagus Nerve Stimulator (VNS):

Vagus Nerve Stimulator, or VNS, stimulates the limbic system, a group of related brain structures that affect mood, motivation, sleep, appetite, alertness and other factors commonly altered by depression. VNS is delivered to the left cervical vagus nerve by a stopwatch-sized generator, implanted just under the skin in the left chest area. VNS delivers pre-programmed, mild, intermittent electrical pulses to the left vagus nerve 24 hours a day. The implantation procedure takes approximately one hour and usually requires no overnight hospitalization.

rTMS vs. VNS

rTMS - Pros:

• Non-invasive and safe.
• Excellent ability to target specific neuron circuits.
• Our data at MindCare Centres show that ~65% of patients respond to treatment.
• Rapid onset of therapeutic benefit – effectiveness only requires 2 to 4 weeks of treatment.
• rTMS can provide therapeutic benefit for treatment-resistant individuals.
• Patients who are currently on medication, do NOT have to stop taking them in order to receive rTMS.

rTMS - Cons:

• Potential side effect: 1 out of 10 patients experience a mild headache post treatment, but can be alleviated with 1 Tylenol.
• Contraindications: a person who has a history of seizures, has a pacemaker, has metal fragments in their skull, or has been a metal worker, may not be able to receive rTMS.
• Not yet FDA approved in the US.

VNS - Pros:

• Has been approved for epilepsy.
• FDA approved in the US.
• Does not cause the side effects normally associated with depression medications, such as weight gain, loss of sexual function, cognitive impairment and insomnia.

VNS - Cons:

• Invasive.
• Effects are modest and it is unclear how to tune pulses to alter brain function.
• Potential side effects:
  
  
• Lack of coordination in the voluntary muscles (ataxia)
• Difficulty breathing, shortness of breath (dyspnea)
• Hoarseness (voice alteration)
• Impaired sense of touch (hypesthesia)
• Inability to sleep (insomnia)
• Increased coughing
• Indigestion (dyspepsia)
• Infection inflammation of the pharynx, throat (pharyngitis)
• Muscle movement of twitching generally associated with stimulation
• Nausea
• Pain
• Prickling of the skin (paresthesia)
• Throat, larynx spasm (laryngismus)
• Vomiting
• Additional side effects of VNS:
  
  
  • Aspiration (fluid in the lungs)
  • Blood clotting
  • Choking sensation
  • Damage to nerve or blood vessels in the surgical area, including the carotid artery and jugular vein

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