Latimer: Update on deep brain stimulation for depression

In a past column I discussed one of the exciting new frontiers in research surrounding treatment of depression—deep brain stimulation. Several techniques of deep brain stimulation are currently in experimental stages and have the potential to become valuable tools in the fight against this devastating disorder. Today, I’d like to provide an update on one particularly encouraging form of deep brain stimulation being studied as a treatment for severe, treatment resistant depression. Intracranial electrical stimulation uses implanted electrodes to send electrical stimulus to certain targeted areas in the brain known to be involved in depression. To date there has been limited research into this treatment, but the small studies that have been done have shown some very positive results. The largest study involves just 20 patients who received 6 months of deep brain stimulation. These patients had to be in an episode of major depression for at least one year and failed to respond to at least four different treatments. The initial results showed a 60 per cent response rate with 30 per cent of participants experiencing remission. Long term results were also encouraging. After a three and a half year follow up period, the average response rate was 64 per cent with 35 per cent experiencing remission. Physical health and psychosocial functioning were also greatly improved over time and there were no significant adverse events reported. All of this is pretty promising especially because of the difficult and chronic nature of severe treatment resistant depression. Typically, less than 20 per cent of these cases result in remission of symptoms and more than 80 per cent experience relapse in spite of aggressive treatment with available options. Quality of life and functioning are usually quite poor for these individuals. Much more research is needed before deep brain stimulation becomes one of the mainstream options for very difficult and severe cases of depression, but it is promising to see such positive results to date even after a long term follow up. It is certainly shaping up to be a safe and effective treatment and a beacon of hope for the 30 percent of depression patients who do not respond well to other less invasive treatment options. If you are experiencing depression, there are several proven treatments already available that may provide relief. Speak with your doctor about what options are available to you. Don’t give up hope—help is available. ••• Okanagan Clinical Trials is conducting current studies in investigational treatments for depression. If you are an adult with depression you may be eligible to participate. Contact the Okanagan Clinical Trials office for a free, no obligation assessment and to learn more about ongoing studies. Call 250 862-8141 for more information. Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials. 250-862-8141

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