What Is The Effectiveness Of Newer Treatments Such As Vagal Nerve Stimulation?

— -- Question: What is the effectiveness of newer treatments such as vagal nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS) for bipolar disorder?

Answer: There is a lot of excitement and active research going into understanding some of the newer treatments for bipolar disorder. These include things like vagus nerve stimulation, repetitive transcranial magnetic stimulation -- or RTMS -- and deep brain stimulation. The common theme for all these different treatments is that they are somatic treatments -- that is to say, we try and impact on the functioning of the brain by changing the activity of certain brain areas in hopes that this is actually going to lead to a remission of the symptoms of bipolar disorder.

We should make a distinction between vagus nerve stimulation and the other two, because that's actually a treatment that's been approved by the FDA in certain specific circumstances, certain kinds of depressions. VNS has not been approved for bipolar disorder specifically, but it may be helpful to some people with bipolar disorder. The other two options, the RTMS and deep brain stimulation, are very experimental in the very early stages of being understood and it's really not clear whether they're going to turn out to be helpful to most people with bipolar disorder.

Having said all of this, it's also good to recognize that all of these treatments that we've been talking about are really quite new, and they haven't really been battle-tested, so to speak, and large numbers of people with bipolar disorder have not actually been treated with these treatments. If a person is experiencing severe symptoms and there's a great need for treatment, most psychiatrists will consider better accepted, more widely available treatments, such as electroconvulsive therapy -- or ECT. So please talk to your psychiatrist and discuss all the options before you decide to go for something that's really highly experimental and with unproven validity.

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