Aug. 24, 2005
For Immediate Release
Contact: Mary Jane Gore
434-924-9241

UVA TO OFFER NEUROLOGICAL PACEMAKER FOR THE MOST SEVERELY DEPRESSED PATIENTS

There’s new hope for patients with severe depression. A neurological pacemaker, similar to a pacemaker for the heart, has been approved by the Food and Drug Administration. Physicians at UVa Health System now can implant this device, which stimulates a patient’s left vagus nerve in the neck, causing the brain to increase levels of serotonin, norepinephrine and dopamine, which are neurotransmitters involved in the regulation of mood.

“These patients must have tried at least four different antidepressant medications before they can be evaluated for the neurological pacemaker,” said Randolph J. Canterbury , M.D., a professor of psychiatric medicine and internal medicine at UVa. “These patients often are very frustrated, and they can be frustrating to treat, because so many other therapies have failed to help them manage their depression. Effective treatment is important, because some of these patients have been severely depressed for years and may be at high risk for suicide or suicidal feelings.”

Studies have shown that after six months with the neuro pacemaker, 8 percent of users report being well. After one and a half years, 48 percent responded that they felt well and 25 percent reported their depression was in remission. Most patients are willing to stick with the treatment, even though it takes time to become effective, Canterbury said.

The pacemaker, manufactured by Cyberonics of Houston, Texas, has been studied for more than four years in clinical trials. One common side effect is hoarseness while the pacemaker is stimulating the nerve, but the vast majority of patients are willing to overlook this in return for the opportunity to feel better, Canterbury  said. Costs of implantation of the neuro pacemaker are expected to be covered by Medicare and Medicaid, which covers the cost of the device for epilepsy treatment.

In addition, Canterbury  is finishing up a clinical trial at UVa’s Center for Psychiatric Clinical Research for a different targeted therapy for depression, Transcranial Magnetic Stimulation (TMS). TMS is a promising noninvasive technique that uses repeated short bursts of magnetic energy to stimulate nerve cells in the brain.

Canterbury  notes that both the neuro pacemaker and TMS potentially could be combined in patients who meet certain criteria. “Using the pacemaker does not rule out other forms of therapy, including drug therapy or psychotherapy,” he explains.

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