CHAPTER 21
Treatment: ECT and VNS
PART 1
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, triggering a brief seizure. ECT can produce significant improvements in symptoms more quickly than medications or psychotherapy. Unfortunately, the use of ECT carries a stigma based on its early use, when high doses of electricity were administered without anesthesia, leading to permanent memory loss and even death. READ MOREECT has come a long way since those days. It is now administered in carefully calibrated doses in a controlled setting. However, because ECT may have side effects such as cognitive impairment and memory loss (usually temporary), it's generally reserved for people who have severe depression accompanied by psychosis, who are in danger of committing suicide, or when other forms of therapy haven't proved effective. LESS
PART 2
Vagus Nerve Stimulation (VNS)
Vagus nerve stimulation (VNS) is a new option for the treatment of chronic, or recurrent, depression. As with ECT, it is indicated for people who have not responded to the usual forms of treatment or who are unable to take medication.In VNS, a device similar to an electronic pacemaker is surgically implanted under the skin on the left side of the chest. A wire from the electrode is connected to the left vagus nerve, stimulating the brain's limbic system. The limbic system regulates mood, appetite, motivation, and sleep patterns, all of which can be affected by depression. READ MORE
It can take some time, up to several months, before VNS has its full effect. Unlike antidepressant medications, however, VNS doesn't cause side effects such as weight gain and sexual dysfunction. VNS can be used in combination with other therapies, including medications and ECT. LESS
