We sometimes receive referrals for individuals with a history of bipolar disorder but who have experienced chronic depression for many years. VNS is sometimes considered where other treatments (mood stabilisers and antidepressants) have been unsuccessful.
There is an emerging evidence base to suggest that VNS might be an option, although evidence from randomised controlled trials (RCTs) is not available. Some of this evidence is below.
We have produced a document that might be helpful for clinicians and patients who are considering this treatment. It aims to address most of the questions that commissioners might have.
MARANGELL LB, SUPPES T, ZBOYAN HA, PRASHAD SJ, FISCHER G, SNOW D, SUREDDI S, ALLEN JC. A 1-year pilot study of vagus nerve stimulation in treatment-resistant rapid-cycling bipolar disorder. Journal of Clinical Psychiatry. 2008; 69(2): 183-189. https://doi.org/10.4088/jcp.v69n0203
MCALLISTER-WILLIAMS RH, SOUSA S, KUMAR A, GRECO T, BUNKER MT, AARONSON ST, CONWAY CR, RUSH AJ. The effects of vagus nerve stimulation on the course and outcomes of patients with bipolar disorder in a treatment-resistant depressive episode: a 5-year prospective registry. International Journal of Bipolar Disorders. 2020; 8(1): 13. https://doi.org/10.1186/s40345-020-0178-4