Service of Psychiatry, Hospital Andre Breton, Saint-Dizier, France.
Neurosurgery Department, Hospital Pitié Salpêtrière, Paris, France.
Int J Psychiatry Clin Pract. 2020 Nov;24(4):349-356. doi: 10.1080/13651501.2020.1779751. Epub 2020 Jul 17.
The treatment-resistant depression (TRD) is a very disabling disease.
The aim of this article is to provide an overview of the therapeutic activity of vagus nerve stimulation (VNS) therapy system in TRD. We summarised the progress made during the last decade in this area.
We conducted a non-systematic review on the efficacy and safety of the VNS therapy for this disease. We analysed the results from acute and long-term studies that utilised this technique. Major electronic databases were searched.
The patients with TRD may show acute and long-term benefit when treated with this technique. There are promising results for VNS therapy for these patients. The level of evidence as an acute treatment option is only 3, but as chronic treatment is 2. This therapy should be offered as an added long-term treatment option for patients with chronic and recurrent difficult to treat depression.
The antidepressant effects of this procedure remain controversial. The clinical trials have produced mixed results, but VNS therapy for TRD has two distinct features that differentiate it from other antidepressant treatments: a sustained therapeutic response obtained in highly resistant depressive disorders, a favourable safety profile and guaranteed compliance.
治疗抵抗性抑郁症（TRD）是一种非常致残的疾病。
本文旨在概述迷走神经刺激（VNS）治疗系统在 TRD 中的治疗活性。我们总结了过去十年在这一领域取得的进展。
我们对 VNS 治疗该疾病的疗效和安全性进行了非系统性综述。我们分析了使用该技术的急性和长期研究的结果。主要电子数据库被搜索。
TRD 患者接受该技术治疗时可能会出现急性和长期获益。对于这些患者，VNS 治疗有希望取得良好的效果。该治疗作为慢性和复发性难治性抑郁症患者的附加长期治疗选择，其证据水平仅为 3 级，但作为慢性治疗则为 2 级。
该程序的抗抑郁作用仍存在争议。临床试验结果喜忧参半，但 VNS 治疗 TRD 有两个明显的特点使其有别于其他抗抑郁治疗方法：在高度抵抗性抑郁障碍中获得持续的治疗反应，具有良好的安全性和保证的依从性。
