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Difficult-to-Treat Depression and the Role of Vagus Nerve Stimulation

Lookup NU author(s): Professor Hamish McAllister-WilliamsORCiD


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© 2022, SLACK Incorporated. It has been argued that reconceptualizing treatment-resistant depression as difficult-to-treat depression (DTD) is of both semantic and clinical benefit. Whereas treatment-resistant depression, by definition, most commonly focuses entirely on repeated pharmacological treatment trials, DTD takes a more holistic perspective, considering all treatment modalities — psychotherapeutic, neurostimulatory, psychosocial, self-help, and pharmacological, from a perspective of a chronic disease management model. A key element of the DTD model is frequent reviews of treatment direction, and whether additional options should be considered, including less commonly used treatments, such as implanted vagus nerve stimulation. This selective review considers the potential role of vagus nerve stimulation, both as an acute treatment and for prophylaxis, the implications of previous electroconvulsive therapy response, and the impact of the treatment on quality of life, in the context of the DTD model of care.

Publication metadata

Author(s): McAllister-Williams RH, Costa T

Publication type: Article

Publication status: Published

Journal: Psychiatric Annals

Year: 2022

Volume: 52

Issue: 7

Pages: 266-271

Online publication date: 01/07/2022

Acceptance date: 02/04/2018

ISSN (print): 0048-5713

ISSN (electronic): 1938-2456

Publisher: Slack Incorporated


DOI: 10.3928/00485713-20220622-01


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