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Old 12-29-2006, 08:45 PM #1
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Default Vegas Nerve Stimulator

Have any of you heard of the VNS for depression?

I am in the process of trying to get it. My Dr. and a lady that works for the company is going to start fighting to get it ok'd by my insurance. I know the fight will be long. I'm looking at most likely a year just for the fight to get it. Then the implant is put in and it takes 8 weeks to get better from the surgery and then it has to be turned on by a wand and then it takes up to 6 months to start seeing any difference, maybe longer.

I just wanted to know if anyone has had this put in or knows of anyone that has had it done.

Thanks,
Ada
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Old 12-29-2006, 09:51 PM #2
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Ada - The VNS is widely used for epilepsy and you could perhaps get lots of answers about it in that Forum.
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Old 12-29-2006, 10:06 PM #3
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Here is one website I found with info for you.

http://www.vnstherapy.com/

I just did a search with the perameters VNS + depression and found lots of information. I hope this helps.
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Old 12-29-2006, 11:19 PM #4
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Ada I met a person during a NAMI convention recently that shared his experiance. I did not attend his presentation, but did hear him speak at the lucnh table, and have somewere in my notes a pamphlet...
I will look for it.

Ada, do you think if you had an SCS nerve stimulator for Tos Pain implanted it may have cross over benefits? I know the implant is not in the same place, but the vegal nerve stim is implanted near the armpit, up into the front of the chest where the brachial nerve area is....I have concern about aggrivating the Tos symptoms.

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Old 12-30-2006, 02:20 PM #5
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Thanks for the information. I have read some and will read the rest.

DiMarie, I never thought about it aggravating the TOS. I do know the chip is put up near the neck area where the TOS problems are. That will be an issue I will talk to when I see the surgeon that will put it in. My PCP has some concerns about me having more problems from it but he also promised me that if it was approved by the FDA we would go after it.

I'm also not sure when but I will end up having my left side TOS surgery eventually and that might be a good ideal before I get the VNS put in. They sent me a tape which I got yesterday plus a lot of info on it so I am going to watch the tape and see how they put it in and what it does.

I'm just so tired of this depression. I'm just trying to find a way to have a better quality of life. Now that I don't have Bill I do know that I need something to help me get to a point to where I can get out of this house. I have a friend who lost her husband 6 years ago and she is a mess. Her daughter doesn't want me in the shape her Mom is in so she thinks this is a good ideal.

Nothing has helped my depression at all. I can't take the meds and I won't let them do the ECT on me. They have wanted to do it and my PCP won't let them either so we both agree on that. I'm just desperate for answers.

I just thought there might be someone on here that has had it implanted for depression. I will go to the other board and read though. Thanks for all of the good info.
Ada
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Old 12-30-2006, 09:48 PM #6
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Arrow Vagus Nerve - Implanted Stimulator

DreamBelieve, before you lie down on the wheeled wagon headed for surgery, DO investigate this procedure very closely. Don't limit your learning to the surgeon and the company website and salespersons ie, customer service representatives. Study up on it. A few have had the device removed for various reasons. Do you know about the side effects?? And read about the studies?

If you find a "support group", feel suspicious if the group is heavily moderated and only has positive glowing reports, as it might be owned (behind the scenes) by the company.

Have you TRULY tried all the possible antidepressants? There are DOZENS and very few people have actually tried all the ADs, just a handful. Which ones have you tried? What happens when you try them? Have you been tried on any of the TriCyclics? Different ADs are not just "different brands". They are not just like cans of green beans with different brand names. They are each distinctively different compounds that interact with your brain neurotransmitter in totally different ways.

80-90% of people who try ADs will eventually find relief, tho some may have to try more than three or will have to try a combination (like adding thryroid, etc) or trying a mood stabilizer. See McMan's website - http://www.mcmanweb.com/article-17.htm

What, exactly, happens - how does your body or mind respond to being on these meds? Do you go off them within the first month or do you give them at least 2 months to work? Or do you have a rapid response, within the first 3 days, that makes you want to stop them? What is that reaction like?

Have you been tried on a mood stabilizer like Lithium or Lamictal? What does your psychiatrist say about your major depressive disorder?

How does psychotherapy do for you? How many different therapists, how many types of therapies have you tried? Do you try them while you are on ADs?

How long have you had depression? Is it every day? Are you often suicidal? Does it keep you from being able to work? To interact positively or productively with your loved ones? Can you leave the house, shop, keep house and cook? Can you function? Do you have self-harming thoughts at times? Have you ever attempted suicide or planned a sucide (yet then didn't do anything)?

What are your depressive symptoms? Lots of anxieties, too? Do you have very little appetite or do you tend to gain weight, more and more -a huge appetite? Do you cry a lot? Do you have trouble getting to sleep or trouble staying asleep or wake up too early and then can't get back to sleep? Do you have a chance to nap during the day? Do you have a lot of stress in your life? Or did you have a lot of stress when you were a child?

What other medications do you take regularly? Or supplements?

My concern is that there is the strong profit-motivation behind this unproven device. Yes, there are patients who report it cured them -- but the cure may not last for long. And consider that placebos of the right color (red has found to be the best) can "cure" depression, too. Do find out a great deal more about all the possible complications and read the studies yourself. (at least the abstracts online).

These are things you should think about, write out, then present to your psychiatrist and ask him if seeing all these information makes him consider anything else? A psychiatrist, seeing you for generally short periods at spread appointments, rather than one hour a week, often has a very spotty notion of you, as an entire person.

I wish you the best in your exporation of DreamBeliever.
Theresa


PS:
I have no desire to have anyone live with depression for year after year. I was very overwhelmed and (I guess) depressed during high school, given that I flirted with suicide by car wreck, over and over, during at least a couple of years. I was depressed in junior high, too. But my "adult form" of depression didn't start until late in my 20's, when I had a great sense of the hopelessness and helplessness of my life, and my life, in all aspects but my children, was falling totally apart.

In that period, I spent an entire year of my life sleeping, sleeping, sleeping - day in, day out, before I was put on a tricyclic, desipramine - a medication I was on for the next 8 years. Actually, it has remained the best AD I've ever been on - and I have recently been considering giving it a trial run again. It is still a highly recommended tricyclic for bipolars. Gave me low blood pressure (bit woozy if I stood up too fast) for a while til I got used to it. Also a dry gummy mouth.

But during that year, I would get up in the morning, fix breakfast for the children, then go to sleep on the couch - they would wake me for lunch, then my husband's phone call before coming home would wake me to make supper. I MIGHT stay awake for a bit after supper, but then it was sleep again. Prior to that year, I had a 7 or so years at least, of near-constant anxiety --- "nerves". After getting on the AD, my "nerves" went away. Everytime I came off the AD, my "nerves" would come back with a vengeance -- until, after a number of years, they no longer did.

When I am depressed, I am never tearful, don't cry (can only really cry when I am doing well). I eat too much, I sleep too much. I vegetate. I retreat from the world. My bedroom becomes my world. ADs get me out of my bedroom.
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Last edited by OneMoreTime; 12-31-2006 at 03:45 AM. Reason: added bit about how depression has affected me virtually my entire life
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Old 12-30-2006, 10:41 PM #7
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Arrow On the Vagal Nerve Stimulation Device ...

For the full picture on AntiDepressants, see here -
http://www.depression-management.inf...pressants.html

info below is from what is the best website I've even encountered on Depression --
http://www.depression-management.info/

Vagus Nerve Stimulation (VNS) Therapy

The FDA approved the VNS Therapy System by Cyberonics, Inc. in July 2005 as an adjunctive long-term treatment for adults with chronic or recurrent treatment-resistant major depression (those who have not had an adequate response to at least four courses of conventional antidepressant treatments).
The FDA's post approval requirements include post approval studies - one study will follow 1000 patients receiving VNS therapy for five years. Click here to view the FDA's approval letter. At the end of this 5-year study of 1000 patients, they will reappraise their approval.

The main reason it was approved is that its use in epilepsy has a long period of verying basic safety, but it has not yet have proven results.

VNS Therapy has been in use in the U.S. since 1997 as an adjunctive treatment of difficult-to-control epilepsy. Some of these patients (being treated for epilepsy) have reported improvement in mood, alertness, and memory.

These benefits may be due to improved seizure control or may be a direct result of VNS therapy - or a combination of both. In other words, the reports of patients may reflect an artifact of the alleviation of epileptic seizure activity. VNS Therapy has been approved for use in Europe and Canada for treatment-resistant depression since 2001.

What is VNS Therapy?
VNS therapy involves stimulating the vagus nerve, which in turn stimulates brain. The vagus nerve extends from the brain through the neck to the major organs - a major communication link between the brain and body.

A small battery-powered device (a pulse generator) similar to a pacemaker is surgically implanted in the chest, connected by a lead to electrodes that connect to the left vagus nerve in the neck. The device sends small periodic electrical pulses to the vagus nerve, which delivers these electrical pulses to the brain. The pulse generator can be programmed externally by a computer, and can be turned off with a special magnet.

How Does VSN Therapy Relieve Depression:
It is not known exactly how VNS therapy relieves depressive symptoms in some people. Stimulating the vagus nerve and the brain through the vagus nerve may trigger the brain to release mood-regulating neurotransmitters or alter the way in which they are transmitted.

How Effective is VNS Therapy for Major Depression?

It appears that 30 - 33 % implanted with a VNS Therapy system report at least a 50% reduction in symptoms of depression.


Only 15% of patients will have full or nearly full remission of the symptoms of depression. Many (but not all) of these patients were still being as well benefitted 2 years after the surgery.

67 - 70% will have no reduction in depression or less than a 50% improvement.
  • There is no way to predict which patients will respond to VNS therapy.
  • It may take several months before any benefits are noted.
  • Improvements may not last.
  • Some people may not benefit at all.
  • Some people may even get worse.
  • There are risks and side effects and special precautions must be taken.
Side effects:
The most common side effects of VNS therapy are hoarseness of voice, cough, tickling in throat, neck pain, shortness of breath, sore throat, and difficulty swallowing. The side effects generally occur during the stimulation periods (which usually are programmed to occur for 30 seconds every 5 minutes). Side effects tend to lessen over time. However, some side effects may continue, especially hoarseness of the voice.

Hoarseness of voice (the most common side effect of VNS therapy - experienced by over half of patients) often continues for the full length of VNS therapy, as long as the stimulator is used.

PRECAUTIONS:
  • VNS Therapy system may interfere with other implanted devices such as cardiac pacemakers.
  • If a person with a VNS therapy device needs an MRI, special precautions must be taken. A person with a VNS stimulator should not have a full body MRI.
  • A person with a VNS therapy device cannot have diathermy. This includes short-wave diathermy, microwave diathermy, or ultrasound diathermy (diagnostic ultrasound is still safe). Diathermy is a therapy (often used by physical therapists) used to treat pain, stiffness, etc, in which a device is applied externally to deliver energy into a person’s body. Diathermy may cause any part of the VNS therapy system to heat up and cause temporary or permanent damage to tissue, nerves, or blood vessels – even if the VNS therapy device is turned off. If there is damage to blood vessels, death could occur. Any part of the system is subject to overheating from diathermy.
  • Even if the pulse generator is removed, the lead (small wires) and electrodes attached to the vagus nerve may be left in place (to avoid damaging the vagus nerve) and special precautions must still be taken in regards to diagnostic MRIs and diathermy treatments.
Click here for the Depression Patients Manual for the VNS TherapyTM System by Cyberonics, Inc. This article is a pdf file written up by the FDA (the Food & Drug Administration of the govenment).
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Old 12-31-2006, 02:34 AM #8
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Ada,
I don't think you sufffered from severe chronic depression, before, that you never got out of bed or took care of yourslef prior to Bills passing. I know it is tough, I lost both parents, not my spouse, so While I had so much depression over thier loss, it still was not Tommy so I can't imagine.

I know when I went through my divorce and had to find a job, with small children and a husband that got a highschool pregnant while I was having our third I was devestated. I was likely much like your friend. I had my kids to think of and when my little one came in and siad don;t cry anymore Mommy, woke me up.

It took a year, about that time I went back to school, took some clases finished my Associate Degree. I joined a group, got involved in community things. I met a few friends that cared to call me, get me out ocasionally. Then I remet my future husband. Years before, we had married others, divorced when spouaes got pregnant by others and then we dated. For 13 years, then decided to marry over 14 years ago.

My depression was gone, although I always have sad events, the parents death, my kids health problems, my health problems, money issues. But what I found was, I needed coping skills. I found a wonderful psych that dealt with chronic pain patients how it affects their life. We had many things that helped reivent me to aperson I like and am.

I first met him to help my daughter and realized, he was my biggest advocate. He knew what I didn't know. I had loss my job as Chief, I was never going back to it, I had so many losses, but I had to morn that life, now at a year I told him, I think I would go to school. He was killed in a car accidnet before I enrolled, but weould be so glad I did it.

From there you know I did go back, I excelled, found a part time job, and do really well there. It is not the life I expected, or the pride I had in my position before. My prior coworkers treat me like a peon with no professional respect anymore......It was one of their own's neice that hit me in the car accidnet....

But, I realized, the Effexor, the prozac, etc. had side effects, they masked, I was much better getting grip, finding good days, crying through bad days and doing it on my own. I take ativan for panic anxiety, but no where like I did. Maybe 30 in a year.

Surgery for the stimulator...if there is a physical reason for depression, not a loss, an emotional crisis is considered. But, Ada, until you morn, find quality of life to go on, I am not sure the stimulator will help.

The person I met that had the surgery, had a life long battle of depression. But, if he were to lose a sibling, or parent, I don;t think his stimulator will avoid his grief.

Our friends that have a more difficult time getting over the loss, were generally people that were totally dependant on their spouse and isolated from others. Finding a friend that also loss a spouse, attending a grief support group, volunteering a day a week at a hospital gift shop etc, may help better then anything to find a new Ada.

Bill would want to watch you and see that your are a star shining and filling others with love and kindness.

All my love.
Di

Last edited by DiMarie; 12-31-2006 at 01:01 PM.
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Old 12-31-2006, 04:24 AM #9
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I work in a surgical suite and this summer was the first time that I heard of a VNS. One of our surgeons implanted one in a male patient to perhaps decrease his seizures.
He was an extreme case due to the fact that his seizures where continuous and limiting his quality of life. This was an attempt after many alternatives were tried.
The procedure did not take long and the gentleman was conscience and speaking before he left the OR.
I spoke to the Doc about it and he did mention that it was also used for certain types of depression. From what I remember it is sort of like a putting in a pacemaker. It is under the skin and when done by a qualified surgeon it is a safe procedure. Do your homework on the VNS and the surgeon you would be referred to.
Judy

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Old 12-31-2006, 02:17 PM #10
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I have lived with depression all of my life to the point that I have been suicidal sense I was old enough to remember. I have tried several times. There is not a day goes by that I donot want to kill myself or live.

I have seen 4 Physchitrist and 2 Physchologist and have been in councelling for 8 years weekly.

I have tried every med out there. I spent 2 years on Prozac and 1 year on zoloft and they made me even more suicidal. I signed myself into a mental institution and because they couldn't find a med that I could take they soon put me out. They said if I couldn't take meds then I could not get well and 2 Physchatrist have wanted to do ect's on me and told me that I would never get well if I don't have this done.

Every med that I have taken has made me worse or the side effects were so bad that I couldn't take them. The more I got into my system the worse the side effects have been.

I deal with every symptom that you have mentioned. 3 years ago I had to sign a living will because the Drs. were worried that I might try to kill myself. I have no doubt in my mind what I have been through and what I continue to go through today.

This is not something we thought of overnight. We have talked about going this route with the vns for the past 2 years. We had to wait until it was approved by the FDA.

I realized a long time ago that I would never get well from depression unless we did something drastic and this is what we have decided to do. I trust my Dr. and I fully intend to study on it more and do what I need to do to understand it but I honestly do see it as my answer and so does my Dr.

I have lived in hell for all of these years with this depression and a person has to walk in my shoes to know what I have been living with. Everyday is a challenge for me to keep from killing myself and there's not a day goes by that I want to die. If a person truly lives with depression the will know what I am talking about.

Thanks for the info. you have given me.

Ada
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