NEW APPROACHES TO TREATMENT

NEW APPROACHES TO TREATMENT
Two newer treatments are geared toward people who haven't responded well to other, more traditional approaches. While they are somewhat similar to ECT, in that they rely on delivering impulses (electrical or magnetic) to achieve results, neither has the proven track record of ECT.
Vagus nerve stimulation
In the summer of 2005, the FDA approved a device known as the vagus-nerve stimulator, as a treatment for adults with depression who haven't responded to four or more other therapies. Extending from the brain through the chest cavity, the vagus nerve helps control your breathing and is linked to the amygdala, hypothalamus, and other parts of the brain that modulate mood and anxiety. A vagus-nerve stimulator is a surgically implanted device similar to a pacemaker that delivers a small electrical impulse to this nerve for about 30 seconds every five minutes. Although vagus nerve stimulation (VNS) was initially developed as a method for controlling epilepsy, researchers found that it improved mood in some people.
The FDA based its approval on research showing that VNS was safe and effective. One study cited in the FDA approval documents showed that 31% of people getting VNS responded well to the treatment in the first 12 weeks of therapy and 45% did after one year. The most common side effects are cough and neck pain. Many people also find that their voice often becomes hoarse while the stimulator is delivering its impulse. Between impulses, though, the person's voice returns to normal.
Although the VNS device is on the market, VNS is a relatively untested treatment that has not yet been proved effective by randomized, controlled trials. For this reason, the consumer group Public Citizen petitioned the FDA not to approve it. The FDA has mandated that Cyberonics, the company that makes the device, conduct studies to monitor its effectiveness. For the most part, this treatment should be reserved for exceptional cases where many other therapies have been tried without success.
Repetitive transcranial magnetic stimulation (rTMS), is traditional therapy, called repetitive transcranial magnetic stimulation (rTMS), is also being tested in several centers. During rTMS, a donut-shaped wand passed along the surface of the scalp focuses magnetic pulses on a small part of the brain. This technique isn't invasive and doesn't cause seizures or require anesthesia, as ECT does. A person undergoing r TMScan sit comfortable in a chair and remain awake during the whole procedure, which takes 30-45 minutes. Usually, it is done once a day for 10 days.
Although results in trials are still inconsistent, the news from what now amounts to a large number of controlled studies is getting better. For example, in one study, using rTMS at different frequencies on different areas of the brain improved depression in people who had not responded to drugs. Researches also have found weekly rTMS helpful to adults with bipolar disorder who are taking lithium.
Http://www.everydayhealth.com/emotional-health/depression/new-approaches-to-treatment...