FDA Approval for VNS in TRD
In July, 2005, the status of VNS in the US moved beyond experimental and investigational and became a standard available option for clinicians with TRD patients following FDA approval. The FDA approved the VNS implant for patients with chronic or recurrent depression, either unipolar or bipolar, with a history of failure of the depression to respond to at least four antidepressant interventions. Patients are not required to have failed ECT to be eligible for VNS. It is not approved for psychotic depression and is only approved for adults 18 years of age and older. Surgeons who implant the device should be experienced in operating within the carotid sheath (usually neurosurgeons or vascular surgeons), and psychiatrists who program the VNS device are required to have training in programming it and be experienced in the management of TRD patients.
Vagus nerve stimulation, originally used to reduce seizures in epilepsy patients, is now under investigation for treatment-resistant depression. A device used for vagus nerve stimulation, the NeuroCybernetic Prosthesis (NCP®) System, recently received Health Canada approval for use in treatment-resistant depression.Nov 28, 2001
The NeuroCybernetic Prosthesis or NCP® System (Cyberonics Inc., Houston, TX) is currently the only commercial device available for VNS. It was originally approved in Canada and the U.S. in 1997, for the reduction of seizures due to refractory epilepsy. In April 2001, Health Canada expanded licensing of the device to include a new indication for "the treatment of chronic or recurrent depression in patients that are in a treatment resistant or treatment intolerant major depressive episode."3 The device has been available in Europe since 1994 for the treatment of epilepsy and received the European CE mark of approval for treatment of major depressive disorder and Bipolar I and II disorder in March 2001.
.From Dr. Nicholas Jenner on his onlinetherapist.blog“I am convinced that codependents come into adulthood seeking the basic connection with others that they failed to find with their parents.In a process of compulsion repetition, they engage in relationships with people similar to their caregivers, trying to solve the original problem.In the specific case of codependency, this means...
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