Comparisons
Comparison to Other Depression Therapies
Vagus Nerve Stimulator (VNS):
Vagus Nerve Stimulator, or VNS, stimulates the limbic system, a group of related brain structures that affect mood, motivation, sleep, appetite, alertness and other factors commonly altered by depression.
VNS is delivered to the left cervical vagus nerve by a stopwatch-sized generator, implanted just under the skin in the left chest area.
VNS delivers pre-programmed, mild, intermittent electrical pulses to the left vagus nerve 24 hours a day.
The implantation procedure takes approximately one hour and usually requires no overnight hospitalization.
rTMS vs. VNS
rTMS - Pros:
- Non-invasive and safe.
- Excellent ability to target specific neuron circuits.
- Our data at MindCare Centres show that ~65% of patients respond to treatment.
- Rapid onset of therapeutic benefit – effectiveness only requires 2 to 4 weeks of treatment.
- rTMS can provide therapeutic benefit for treatment-resistant individuals.
- Patients who are currently on medication, do NOT have to stop taking them in order to receive rTMS.
rTMS - Cons:
- Potential side effect: 1 out of 10 patients experience a mild headache post treatment, but can be alleviated with 1 Tylenol.
- Contraindications: a person who has a history of seizures, has a pacemaker, has metal fragments in their skull, or has been a metal worker, may not be able to receive rTMS.
- Not yet FDA approved in the US.
VNS - Pros:
- Has been approved for epilepsy.
- FDA approved in the US.
- Does not cause the side effects normally associated with depression medications, such as weight gain, loss of sexual function, cognitive impairment and insomnia.
VNS - Cons:
- Invasive.
- Effects are modest and it is unclear how to tune pulses to alter brain function.
- Potential side effects:
- Lack of coordination in the voluntary muscles (ataxia)
- Difficulty breathing, shortness of breath (dyspnea)
- Hoarseness (voice alteration)
- Impaired sense of touch (hypesthesia)
- Inability to sleep (insomnia)
- Increased coughing
- Indigestion (dyspepsia)
- Infection inflammation of the pharynx, throat (pharyngitis)
- Muscle movement of twitching generally associated with stimulation
- Nausea
- Pain
- Prickling of the skin (paresthesia)
- Throat, larynx spasm (laryngismus)
- Vomiting
- Additional side effects of VNS:
- Aspiration (fluid in the lungs)
- Blood clotting
- Choking sensation
- Damage to nerve or blood vessels in the surgical area, including the carotid artery and jugular vein
Click here to view medical journal articles on VNS and rTMS comparison
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