A new study led by Helen S. Mayberg, MD, professor in the Departments of Psychiatry and Behavioral Sciences, Neurology and Radiology at Emory University School of Medicine, shows that deep brain stimulation (DBS) is “a safe and effective intervention for treatment-resistant depression in patients with either unipolar major depressive disorder (MDD) or bipolar ll disorder (BP).”
Bipolar spectrum disorder (also referred to as manic depression) is basically characterized by bouts of mania or hypomania alternating between episodes of depression. “Although people with bipolar ll disorder do not have full manic episodes, depressive episodes are frequent and intense, and there is a high risk of suicide.”
Up until now, doctors have found that many antidepressant drugs used to treat the disorder have been known to cause sufferers to “switch” into a hypomanic or manic episode.” However, according to Mayberg and co-investigators Paul E. Holtzheimer, MD, lead psychiatrist and now associate professor and director of the Mood Disorders Service, Dartmouth Medical School, and neurosurgeon Robert E. Gross, MD, PhD, associate professor in the Departments of Neurosurgery and Neurology at Emor,”using DBS treatments provide a “safer” alternative by using high-frequency electrical stimulation targeted to a predefined area of the brain specific to the particular neuropsychiatric disorder.
17 trial participants were given single-blind stimulation for a month, followed by active stimulation for 24 weeks. They did not know if the DBS stimulators were on or off during that time. They were then evaluated for up to 24 months following onset of active stimulation. According to the researchers there was a “significant decrease in depression and increase in function were associated with continuing stimulation. Remission and response rates were 18% and 41% after 6 months, 36% percent after one year. In addition, rates rose to 58% and 92% after two years of active stimulation.” It was also shown that patients who achieved remission did not suffer any spontaneous relapse
“Most of these patients have been in a depressed state for many years and are disabled and isolated,” cited Holtzheimer. “As their depression improves, they need a process to help them achieve full recovery that includes integration back into society. We hope to optimize the rate of improvement for these patients by using a model of care that provides psychotherapeutic rehabilitation built on evidence-based psychotherapy but tailored to the specific individual’s situation.”
The study was funded by grants from the Dana Foundation, Stanley Medical Research Institute, Woodruff Foundation, and Emory Healthcare. TheDBS devices were donated by St. Jude Medical Neuromodulation Inc., which was not involved in the study in any other way.
The study was published Online First by Archives of General Psychiatry, one of the JAMA/Archives journals.
Source: Woodruff Health Sciences Center at Emory University in Georgia
Those seeking help for bipolar disorder in the Danbury area can go online to http://www.medicinenet.com/bipolar_disorder/danbury-ct_city.htm for more information as well as a listing of doctors in the area