Patients who received four different treatments for depression, including ECT, and did not get relief, responded extremely well to deep brain stimulation (DBS) in recent clinical trials. But according to the Mayo Clinic, there are significant risks associated with this form of treatment for depression.
What is Treatment-Resistant Depression?
Treatment-resistant depression is clinical depression that does not respond to medication or different types of psychotherapy designed to treat it. Approximately 10 to 20 percent of people with clinical depression experience this problem, according to the November/December 2008 issue of the Psyhcotherapy Networker.
In the past, electro-convulsive therapy (ECT) was the last option. The side-effects of ECT, such as a flattening of emotions and memory problems are not long-lasting, but many people find them to be disturbing. In addition, ECT does not help everyone and the benefits are temporary.
What is Deep Brain Stimulation for Treatment-Resistant Depression?
Deep brain stimulation treatment for depression is a surgical procedure. Electrodes are implanted directly into the brain’s cingulate gyrus, the portion of the brain that effects sensory input, emotions, pain and aggression. The electrodes are wired to a generator implanted near the collarbone.
DBS is a Form of Depression Treatment Known as Neuromodulation
For several years researchers have been looking alternative types of depression treatments, known as "neuromodulation."
In fact, the FDA has already approved vagus nerve stimulation (VNS) as well as transcranial magnetic stimulation (rTMS) treatments for depression. Both treatments involve the use of electrodes to stimulate various nerves and the brain.
Positive Results of Deep Brain Stimulation for Depression
But according to the Networker, the studies regarding VNS and rTMS have not been encouraging, although reports of DBS have been very positive.
The Networker cites a study appearing in the September 2008 issue of Biological Psychiatry which reports that many people in the trials have gone into complete remission. Some people reported that they felt as if a switch turned off their depression. The results seem to be long-lasting as well.
Clinical Trials for DBS
Clinical trials for DBS depression treatment are taking place in Chicago, Dallas, and New York.
Side Effects of Deep Brain Stimulation
According to the Mayo Clinic, DBS is approved for use by the FDA in Parkinson's patients. Some of the side effects experienced by some of these patients are:
- Panic attacks
- Manic episodes
- Speech difficulty
- Movement problems
- Increased suicidal thoughts and behavior
Surgical risks are also present, such as infection, stroke, bleeding in the brain, and death.
Treatment Protocols for Depression
People suffering from clinical depression are usually prescribed medication and/or psychotherapy. Many medications and types of therapy provide people with great relief. Those who do not get relief through these means are often referred for ECT.
Neuromodulation treatments, especially Deep Brain Stimulation (if it receives FDA approval) may help those who cannot tolerate or have not gotten relief from ECT. However, it is a highly invasive procedure and comes with significant risks and a high price tag.
Success Reported with DBS in 2012
On April 14, 2012, CNN reported a recent dramatic story, of a patient whose life was changed by DBS. Neurologist Dr. Helen Mayberg operated on over 31 patients with treatment resistant depression or bipolar disorder since 2005, applying DBS to an area of the brain known as area 25. Approximately four out of six, or 66% of patients get relief. Mayberg states that they do not yet understand how or why DBS works, or why it doesn't work for everyone.
Related Information
Readers might be interested in this book, which includes information about how different parts of the brain affect psychological health and behavior.
This article explains the differences between unipolar vs. bipolar depression.
This article was updated 4/14/2012. This article is for information purposes only and is not a substitute for mental health or medical care. People who have troubling symptoms should see their medical doctor or mental health professional.
Lisa C. DeLuca - Lisa C. DeLuca is a psychotherapist/social worker who works with families and teens. She also treats panic and anxiety disorders.
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