" In February 2006, Sullivan became one of the first Mid-South residents to have a vagus nerve stimulation, or VNS, device implanted in her chest. It is about the size of a pocket watch and is implanted just below her collar bone. "

" Now every three minutes, the implanted generator sends a 30-second burst of electricity to her left vagus nerve, which carries it into her brain. The only obvious sign comes when Sullivan's voice suddenly becomes hoarse, a treatment side effect. "

"Sullivan credits the treatment with helping her cope with her mother's surgery, but also with helping to lift a cloud that's dogged her for decades. "

"Her depression has led to at least four suicide attempts, more than 20 hospitalizations, 50 or 60 different medications, a surgical procedure and a crushing hopelessness that made leaving the house -- or even a chair -- difficult. "

""I was scared to go to sleep. I didn't want to be alone. I thought about suicide all the time," she said. "

"VNS won federal approval in 1997 to help control seizures. Then reports started surfacing of depression symptoms easing in patients who had the device implanted for seizure control, Dr. Roger Vogelfanger said. He is a Memphis psychiatrist and the physician who suggested Sullivan consider the device. "

"Like electroconvulsive therapy (ECT), VNS is believed to work by using electricity to influence the production of brain chemicals called neurotransmitters. Depression has been tied to an imbalance in those chemicals. "

"In studies leading to its 2005 federal Food and Drug Administration approval as a depression treatment, the device showed no benefit during the first two or three months. But after one year, 20 to 30 percent of patients reported significant improvements. Half of them reported symptoms had almost completely disappeared. "

"But other patients didn't improve or got worse. The studies involved more than 200 patients whose depression hadn't lifted despite treatment with at least four different medications with or without ECT. Nearly 21 million Americans suffer a bout of clinical depression annually. It's not clear what percent might fail other treatments and be a VNS candidate. "

"The device's parent company, Cyberonics, said it has now been implanted in about 2,200 patients in hopes of easing depression. "

"In February, the Centers for Medicare and Medicaid Services (CMS) signaled its intent not to cover the treatment's roughly $25,000 price tag. The estimate includes the cost of the device and surgery to implant it. CMS oversees the federal health programs covering older, disabled and poor Americans, including more than 43 million enrolled in Medicare. "

" "CMS is proposing that there is sufficient evidence to conclude that vagus nerve stimulation is not reasonable
... read the whole article