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Psychiatrists' work provides new hope for depression patients

Vagus Nerve Stimulator implanted under skin

By John Gedraitis

I'm sorry, but we've done everything we can." It's a phrase patients never want to hear, and one that, for a long time, physicians were forced to use with patients with chronic or recurrent depression.

Now, thanks to a new program clinically tested by KU School of Medicine-Wichita psychiatrists at the Psychiatric Research Institute, a device called a Vagus Nerve Stimulator (VNS) offers new hope for relief.

"This is the first novel nonmedication treatment for depression approved by the Food and Drug Administration," said Dr. Michael Burke, associate professor of psychiatry and behavioral sciences and principal investigator for the local program. "It involves implanting a pacemaker-like device under the skin above the breast. The device then sends electrical impulses to the brain along the vagus nerve to those areas thought to be involved with mood disorders.

"The FDA has recently approved the device for 'treatment resistant' depression," he said. "It is especially designed for patients who have had no successful outcomes to at least four treatment trials with medications."

One of the first patients in Kansas and the United States to have the device implanted was Ruth Nord of Wichita.

"It has made a tremendous difference," she said. "Before, I tried all kinds of drug combinations and electronic convulsive therapy, and nothing seemed to work. Now, I can enjoy life again, and my family has said they even enjoy being around me.

"I truly believe that this device has saved my life," she said. "Before, I made two suicide attempts, and I know I would have kept trying until I succeeded."

Although Nord still has periods of depression, they are of short duration and are not as deep as those prior to the device being implanted. The only significant side effect is hoarseness in her voice that occurs when the device cycles.

Wichita was one of 18 sites nationwide that participated in the trials and was one of the first to implant the device. Others include Baylor, Brown University, Stanford, NYU, Washington, RushUniversity Medical Center and Massachusetts General Hospital, among others.

"Our research has brought major treatment advances in Alzheimer's disease, anxiety disorders, clinical depression and schizophrenia, to name a few diseases, years before they were available in routine clinical practice," said Dr. Sheldon Preskorn, professor and chair of psychiatry and behavioral sciences and a co-investigator in the VNS effort. "In addition, our research often provides totally (or nearly) free care representing millions of dollars every year to citizens in this region, since the care is underwritten by the sponsors of the research.

"Finally," he said, "this research means that our medical students and residents are also being exposed to cutting-edge new treatments, as well as being exposed to academic physicians who are at that cutting edge and to the disciplined, systematic and careful way that clinical medicine is practiced in clinical trials."

The KUSM-W Department of Psychiatry and Behavioral Sciences is working to become a premier VNS access sites. For more information, contact the department at (316) 293-2647.

Copyright 2005, an official employee publication from the Office of University Relations.