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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Sara T on July 29, 2000, at 13:20:15
Fellow Babblers,
I thought some of you would be interested in this article that appeared in today's Miami Herald.
Sara T.Published Saturday, July 29, 2000, in the Miami Herald
Pacemaker for depression to get UM test
BY CHRISTINE MORRIS
cmorris@herald.comA promising new treatment for depression in patients who have not responded to medication will be tested in the coming months at the University of Miami. Patients will be implanted with a pacemaker that stimulates a nerve connected to the brain -- an approach that has reduced seizures and significantly improved mood in people with epilepsy.
About 18 million people in the United States and 340 million worldwide suffer from depression, according to the journal of the Society of Biological Psychiatry. Depression, a chronic, often disabling illness, is usually treated with medication, psychotherapy or a combination of both.
That treatment is ineffective for 10 percent to 20 percent of sufferers. With the new pacemaker, ``we have a very good possibility of helping them extensively without any side effects,'' said Dr. Paul J. Goodnick, professor of psychiatry and director of the UM study.
Thirty patients participated in the nerve stimulation. About 40 percent showed a marked improvement in mood and ability to function, according to study author A. John Rush, a psychiatrist at the University of Texas Southwestern Medical Center at Dallas.
``We would have been pretty excited with a 20 percent response rate,'' given that other treatments had failed these patients, Rush said. ``When we got a 40 percent response rate, that was very exciting.''
Three months later, the treatment was still effective. In some cases, the benefit had increased, suggesting it may truly be a long-term solution.
TWOFOLD BENEFIT
``If it's proved to be effective, you have a treatment with two potential benefits,'' Rush said. ``It may work when other treatments don't, or it may make treatments work again. Secondly, it's a treatment that keeps on working without the patient having to do anything,'' such as remembering to take pills.
``If all that's true, it's a whole new ball game,'' Rush said.
The implanted device, called the NeuroCybernetic Prosthesis System, is a generator about the size of a half-dollar. It is put in the left chest wall in an outpatient operation with a regional or local anesthetic, Goodnick said.
It stimulates the left vagus nerve, which is connected to the limbic system, the portion of the brain that controls sleep, appetite and many emotions and is involved in depression.
Previous studies also suggest that the stimulation changes levels of serotonin, norepinephrine and other neurotransmitters that affect depression.
``The question becomes which of those effects are accounting for the therapeutic improvement,'' Rush said. ``As we learn more about the biology of depression, then we'll be a little closer to understanding how it works.''
CONTROL GROUP
Doctors turn on the stimulation with a programming ``wand.'' In the UM study, half of the 10 to 20 participants will not get the stimulation in the first eight weeks of the study. Their responses will be compared with patients who do get the stimulation. Patients will not know which group they are in.
After the initial phase, all participants will get the stimulation.
Twenty centers will participate in this study, which is sponsored by Cyberonics, maker of the NeuroCybernetic Prosthesis System.
Doctors are confident about the safety of the device because about 6,000 epileptics worldwide have been implanted with it. Many of them experienced a reduction in seizures. But even patients who got no relief from seizures reported improvements in mood as a result of the treatment, Rush said.
Contact Us
Copyright 2000 Miami Herald
Posted by Sunnely on July 29, 2000, at 22:11:43
In reply to Pacemaker for Depression Article, posted by Sara T on July 29, 2000, at 13:20:15
> Twenty centers will participate in this study, which is sponsored by Cyberonics, maker of the NeuroCybernetic Prosthesis System.
Hi Sara,Thanks for the excellent info on this subject. Please allow me to add my 2 cents.
A double-blind, randomized, controlled study of the effectiveness of VNS (vagus nerve stimulation) for treatment-resistant depression, involving 20 centers is planned for this summer. The hope is that 200 or more people will be enrolled in this pivotal study. Persons suffering from possible treatment-resistant depression interested in joining the study will have to be referred by their physicians to Cyberonics. The telephone number is (888) 748-1657.
With regard to cost, it was estimated the cost for the equipment as $9200 per patient and the total cost, including implantation, varies between $12,000 and $25,000. Most federal and private insurance companies provide reimbursement for VNS in refractory epilepsy. Comparison costs are an estimated $1000 per year for an antidepressant medication or $10,000 to $30,000 for an acute course of ECT (electroconvulsive therapy) followed by 1 year of maintenance ECT.
Until trials are completed, compassionate use of VNS appears justified in persons with the most severe, chronic, and treatment-resistant depression.
Posted by shar on July 29, 2000, at 22:12:52
In reply to Pacemaker for Depression Article, posted by Sara T on July 29, 2000, at 13:20:15
Sara,
That is very interesting! If it becomes a reality in my lifetime I say sign me up! Here's the plan:Get the pacemaker while still on meds
Have dr. sedate me for 2 weeks min.
After all meds are gone from system I slowly awakeTa-daa! All better now!
Shar
> Fellow Babblers,
>
> I thought some of you would be interested in this article that appeared in today's Miami Herald.
> Sara T.
>
> Published Saturday, July 29, 2000, in the Miami Herald
>
>
> Pacemaker for depression to get UM test
> BY CHRISTINE MORRIS
> cmorris@herald.com
>
> A promising new treatment for depression in patients who have not responded to medication will be tested in the coming months at the University of Miami. Patients will be implanted with a pacemaker that stimulates a nerve connected to the brain -- an approach that has reduced seizures and significantly improved mood in people with epilepsy.
>
> About 18 million people in the United States and 340 million worldwide suffer from depression, according to the journal of the Society of Biological Psychiatry. Depression, a chronic, often disabling illness, is usually treated with medication, psychotherapy or a combination of both.
>
> That treatment is ineffective for 10 percent to 20 percent of sufferers. With the new pacemaker, ``we have a very good possibility of helping them extensively without any side effects,'' said Dr. Paul J. Goodnick, professor of psychiatry and director of the UM study.
>
> Thirty patients participated in the nerve stimulation. About 40 percent showed a marked improvement in mood and ability to function, according to study author A. John Rush, a psychiatrist at the University of Texas Southwestern Medical Center at Dallas.
>
> ``We would have been pretty excited with a 20 percent response rate,'' given that other treatments had failed these patients, Rush said. ``When we got a 40 percent response rate, that was very exciting.''
>
> Three months later, the treatment was still effective. In some cases, the benefit had increased, suggesting it may truly be a long-term solution.
>
> TWOFOLD BENEFIT
>
> ``If it's proved to be effective, you have a treatment with two potential benefits,'' Rush said. ``It may work when other treatments don't, or it may make treatments work again. Secondly, it's a treatment that keeps on working without the patient having to do anything,'' such as remembering to take pills.
>
> ``If all that's true, it's a whole new ball game,'' Rush said.
>
> The implanted device, called the NeuroCybernetic Prosthesis System, is a generator about the size of a half-dollar. It is put in the left chest wall in an outpatient operation with a regional or local anesthetic, Goodnick said.
>
> It stimulates the left vagus nerve, which is connected to the limbic system, the portion of the brain that controls sleep, appetite and many emotions and is involved in depression.
>
> Previous studies also suggest that the stimulation changes levels of serotonin, norepinephrine and other neurotransmitters that affect depression.
>
> ``The question becomes which of those effects are accounting for the therapeutic improvement,'' Rush said. ``As we learn more about the biology of depression, then we'll be a little closer to understanding how it works.''
>
> CONTROL GROUP
>
> Doctors turn on the stimulation with a programming ``wand.'' In the UM study, half of the 10 to 20 participants will not get the stimulation in the first eight weeks of the study. Their responses will be compared with patients who do get the stimulation. Patients will not know which group they are in.
>
> After the initial phase, all participants will get the stimulation.
>
> Twenty centers will participate in this study, which is sponsored by Cyberonics, maker of the NeuroCybernetic Prosthesis System.
>
> Doctors are confident about the safety of the device because about 6,000 epileptics worldwide have been implanted with it. Many of them experienced a reduction in seizures. But even patients who got no relief from seizures reported improvements in mood as a result of the treatment, Rush said.
>
>
>
>
>
>
>
>
>
> Contact Us
> Copyright 2000 Miami Herald
>
Posted by shar on July 29, 2000, at 22:17:34
In reply to Re: Pacemaker for Depression Article - Addendum, posted by Sunnely on July 29, 2000, at 22:11:43
I assume participants will not be taking meds (ADs)?
Shar
> > Twenty centers will participate in this study, which is sponsored by Cyberonics, maker of the NeuroCybernetic Prosthesis System.
>
>
> Hi Sara,
>
> Thanks for the excellent info on this subject. Please allow me to add my 2 cents.
>
> A double-blind, randomized, controlled study of the effectiveness of VNS (vagus nerve stimulation) for treatment-resistant depression, involving 20 centers is planned for this summer. The hope is that 200 or more people will be enrolled in this pivotal study. Persons suffering from possible treatment-resistant depression interested in joining the study will have to be referred by their physicians to Cyberonics. The telephone number is (888) 748-1657.
>
> With regard to cost, it was estimated the cost for the equipment as $9200 per patient and the total cost, including implantation, varies between $12,000 and $25,000. Most federal and private insurance companies provide reimbursement for VNS in refractory epilepsy. Comparison costs are an estimated $1000 per year for an antidepressant medication or $10,000 to $30,000 for an acute course of ECT (electroconvulsive therapy) followed by 1 year of maintenance ECT.
>
> Until trials are completed, compassionate use of VNS appears justified in persons with the most severe, chronic, and treatment-resistant depression.
This is the end of the thread.
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