DEPRESSION RESEARCH UPDATE
Findings from three new studies in major depression indicate that
1 Vagus nerve stimulation improves the quality of life of patients with treatment-resistant depression;
2 Higher blood levels of omega-3 fatty acids have been linked to improved depression symptoms in patients with both depression and heart failure;
3 Treating depression in teens may benefit parents’ mental health.
Vagus nerve stimulation improves quality of life in patients with depression
Adding vagus nerve stimulation (VNS) to antidepressant therapy significantly improved the quality of life of patients with treatment-resistant depression.1 Self-reported quality of life assessments were used in a multicenter, longitudinal registry to compare the antidepressant efficacy of VNS plus antidepressant treatment (328 patients) with antidepressant treatment alone (271 patients). The patients had either unipolar or bipolar depression and experienced treatment failure in at least 4 antidepressant trials.
On about 10 of the 14 measures, patients in the VNS group had a clinically meaningful quality of life improvement of 34% to 40%, which was below the classically defined antidepressant response of 50%. Patients in this group also had significant gains in quality-of-life measures, such as mood, ability to work, social relationships, family relationships, and leisure activities compared with those who received only treatment as usual.
Clinical implications. “When evaluating patients with treatment-resistant depression, we need to focus more on their overall well-being. A lot of patients are on as many as three, four, or five antidepressant medications, and they are just barely getting by. But when you add a vagus nerve stimulator, it really can make a big difference in people’s everyday lives,” said principal investigator Charles R. Conway, MD, professor of psychiatry at Washington University.
1. Conway CR, Kumar A, Xiong W, et al. Chronic vagus nerve stimulation significantly improves quality of life in treatment-resistant major depression. J Clin Psychiatry. 2018;79:18m12178.
2. Jiang W, Whellan DJ, Adams KF, et al. Long-chain omega-3 fatty acid supplements in depressed heart failure patients: results of the OCEAN trial. JACC Heart Fail. 2018;S2213-S1799:30226-30229.
3. Howard KR. Parental depressive symptoms over the course of treatment for adolescent depression. Presented at the American Psychological Association Annual Convention. San Francisco; August 9-12, 2018. ❒