Vagus nerve stimulation at home is promising for postpartum depression

Vagus nerve stimulation at home is promising for postpartum depression

A new study finds that a noninvasive home treatment of auricular vagus nerve stimulation (aVNS) is well tolerated and is associated with a significant reduction in postpartum depression and anxiety symptoms.

In a small pilot proof-of-concept study of 25 women with postpartum depression receiving 6 weeks of daily AVNS treatment, results showed that 74% achieved a response and 61% achieved remission, as indicated by low scores on the Hamilton Depression Rating Scale (HAM-). D17).

Dr. Christina M. Diliganidis

Although gaseous electrical stimulation of the vagus nerve was approved by the U.S. Food and Drug Administration for treatment-resistant depression in 2005, it does have implantation risks, infection, and significant side effects, said Christina M. Health, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, said Medscape Medical News.

“This newer approach, the percutaneous auricularis neuralgia, is non-invasive, well-tolerated, and has shown initial efficacy in major depression in men and women,” she said.

The results were presented at the 2022 American Society of Clinical Psychopharmacology (ASCP) annual meeting.

Possible alternative to medication

“Because AVNS is a non-invasive treatment that can be given at home, we wanted to test whether this approach was safe, feasible, and could reduce depressive symptoms in women with postpartum depression, as many of these women have barriers to accessing postpartum depression. Diliganidis said.

The Auricular VNS uses surface skin electrodes to stimulate the nerve endings of the vagus nerve branch located on the surface of the outer ear. These nerve endings travel to the brain, she said, where they have been shown to modulate brain communication in areas important for regulating mood and anxiety.

Diliganidis noted that evidence-based treatments for postpartum depression include psychotherapy and antidepressants. However, some women find it difficult to get weekly psychotherapy, and when antidepressants are prescribed, many are reluctant to take them if they are breastfeeding due to concerns that the drugs will get into breast milk, she said.

Diliganidis added that although most antidepressants are safe while breastfeeding, many women postpone treatment with antidepressants until they are finished breastfeeding, which can delay treatment for postpartum depression.

“At-home treatments reduce many of the barriers women face to current treatments, and this intervention [of aVNS] “It does not affect lactation, it is not a pharmacological approach,” she said.

The researchers enrolled 25 women (mean age, 33.7 years) diagnosed with postpartum depression. Ten of the women (40%) took a fixed dose of antidepressant medication.

Participants performed 6 weeks of a daily 15-minute open aVNS program at home. They were then observed without intervention for an additional two weeks. The women also completed medical, psychological, and safety interviews throughout the study period.

promising results

At baseline, the mean HAM-D17 was 18.4, and was similar to that of (17.8) on and off (18.9) antidepressants.

By week 6, the average overall HAM-D17 score had decreased by 9.7 points overall compared to the baseline score. For participants on antidepressants, HAM-D17 decreased by 8.7 points; For women on antidepressants, it decreased by 10.3 points.

Additionally, 74% of the women achieved a response to treatment and 61% achieved remission of depressive symptoms.

The most common side effects were discomfort (n = 5 patients), headache (n = 3), and dizziness (n = 2). All resolved without interference.

Dr. Anita Clayton

Comment on the results for Medscape Medical News, Anita Clayton, MD, professor and chair of the division of psychiatry and neurobehavioral sciences, University of Virginia School of Medicine, Charlottesville, said the study was “very interesting.”

Clayton, who was not involved in the research, also noted the “very high” response and rates of quietness.

“So, I think this has promise and that it would be beneficial to do a study where you look at a placebo versus this treatment,” she said.

“Many women are afraid to take medication after delivery, even in the postpartum period, unless they have severe pre-existing depression. This is not a medication, and it appears that it may be beneficial even in pregnant women, although studies in pregnant women are difficult to conduct” .

American Society of Clinical Psychopharmacology (ASCP) 2022 Annual Meeting. Summary 3003547. Filed May 31, 2022.

The study was funded by Nisos Corporation. Deligiannidis received contracted research funds from Nesos Corporation to conduct this study. She also serves as a consultant for Sage Therapeutics, Brii Biosciences, and GH Research. Clayton reports financial relationships with Dare Bioscience, Janssen, Praxis Precision Medicines, Relmada Therapeutics, Inc, Sage Therapeutics, AbbVie, Brii Biosciences, Fabre-Kramer, Field Trip Health, Mind Cure Health, Ovoca Bio, PureTech Health, S1 Biopharma, and Takeda / Lundbeck, Vella Bioscience, WCG MedAvante-ProPhase, Ballantine Books/Random House, Changes in Sexual Performance Questionnaire, Guilford, Euthymics Bioscience, and Mediflix publications.

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2022-06-01 22:22:02

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