Vagus Nerve Stimulation (VNS)
Vagus nerve stimulation is a brain stimulation approach that has been available since 2005 for treatment-resistant depression. VNS is indicated for use as an adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.
SeattleNTC psychiatrists will consider VNS as one of the possible treatments that may be appropriate for patients with treatment-resistant depression. Unfortunately, most health insurance companies do not cover VNS. However, if the decision is still made to pursue VNS, a referral will be made to a neurosurgical consultant for consultation and surgical implantation. The SeattleNTC team of psychiatrists can then monitor the treatment during subsequent office visits.
Deep Brain Stimulation (DBS)
Deep brain stimulation (DBS) uses a surgically implanted medical device, similar to a cardiac pacemaker, to deliver carefully controlled electrical stimulation to precisely targeted areas in the brain. It works by electrically stimulating specific structures that control unwanted symptoms.
Major Depressive Disorder
From 2011 to 2014, SeattleNTC psychiatrist Dr. Ken Melman was the local principal investigator for a multisite, double blind, sham controlled study of deep brain stimulation for Major Depressive Disorder. In this study, Dr. Melman worked closely with neurosurgical collaborators in the Swedish Neuroscience Institute. Unfortunately, this study closed in 2014 and is no longer accepting new subjects.
Obsessive-Compulsive Disorder (OCD)
Dr. Melman and neurosurgical collaborators at the Swedish Neuroscience Institute continue to offer consultation and treatment with deep brain stimulation for patients with chronic, severe, treatment-resistant obsessive-compulsive disorder as an alternative to anterior capsulotomy under a FDA Humanitarian Device Exemption (HDE) for Medtronic’s Reclaim® DBS Therapy.
Transcranial Direct Current Stimulation (tDCS)
Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity.
Several studies suggest it may be a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson’s disease, and chronic pain. Research has also demonstrated cognitive improvement in some patients undergoing tDCS. Currently, tDCS is not an FDA-approved treatment; as such, it cannot be offered by SeattleNTC.
Why should my VNS or DBS be managed by the physicians at SeattleNTC?
Invasive neurostimulation, also called brain stimulation, can be a life-saving intervention for patients with severe and treatment-resistant depression. Psychiatric neurostimulation devices and the conditions they treat are highly complex and should be managed by a specially trained psychiatrist and treatment team. Dr. Kerns is one of the few psychiatrists in in the world who has been formally trained in psychiatric neurostimulation. Through her Neurostimulation Fellowship at the Medical University of South Carolina, Dr. Kerns has experience managing patient with VNS, DBS and even more experimental forms of neurostimulation such as EPCS (epidural cortical stimulation).
"I would say that SeattleNTC is an incredible partner for anyone suffering any kind of mental health issue. Again, I can primarily speak for those with depression, but I would tell anyone who’s dealing with mental health issues: SeattleNTC is on the cutting edge. The staff and the doctors are extremely caring and extremely talented people. Compassionate. Very interested in the outcome and the ongoing of all their treatment." - ECT & TMS patient - Karen (45yo)
"I started the TMS. Overnight, it's like I came back to life. So far, it's kept sticking around and I've reconnected with my church groups, my community of work." – TMS patient - Jim (62yo)
"I'm very, very satisfied with the results and I think I made the right decision. SeattleNTC and Dr. Melman came highly recommended in this field. One of the best! This gave me a lot of confidence going into the treatment. I wake up every morning with gratefulness that I am now happy. My energy level is off the charts. My family is no longer suffering due to my depression. The closeness and love we share is priceless!" – TMS patient – Jessica (41yo)
"There’s never a glitch or a moment of stress. Everybody’s attuned to you. Somebody’s there to make sure you’re ok. It’s amazing. They hold your hand through the whole procedure. I can’t say enough good about it" - ECT patient – Bertie (71yo)
"I knew that there had to be something. I couldn’t had run out of luck at this point." - TMS patient – Maria (45yo)
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