Neues zur Vagusnervstimulation und Tiefenhirnstimulation bei Depressionen

Zusammenfassung

Die kürzlich in den USA erfolgte Zulassung der Vagusnervstimulation (VNS) zur adjuvanten Therapie der Depression hat die Fachdiskussion über die so genannten biophysikalischen Behandlungsverfahren erneut angeregt. Es ist auch von Seiten der Betroffenen mit Fragen zu diesen Methoden und einem vermehrten Informationsbedarf zu rechnen. Neben der VNS wurden aber bereits seit längerem auch die Möglichkeiten einer Tiefenhirnstimulation (deep brain stimulation – DBS) in der Therapie psychiatrischer Störungen erörtert. In einer kürzlich veröffentlichten Pilotstudie zur DBS bei Patienten mit therapieresistenter Depression wurden sowohl interessante Kurzzeiteffekte beschrieben, aber auch klinisch relevante Daten über einen längeren Zeitraum vorgelegt.

In der folgenden Übersicht sollen beide Verfahren dargestellt und kritisch bewertet werden. Es ist zu erwarten, dass diese oder ähnliche biophysikalische Ansätze in der Zukunft eine größere Rolle in der Therapie schwerer oder chronischer Depressionen spielen werden.

Summary

The recent FDA approval of Vagus Nerve Stimulation (VNS) in the long-term treatment of patients with depression has again drawn attention to non-pharmacological biophysical treatment strategies. Regarding these methods there isa need for objective information for both patients and practitioners. Besides VNS, Deep Brain Stimulation (DBS) has long been considered asa treatment option in psychiatric disorders. According to a recent pilot study there is now first evidence of clinically relevant shortand long-term effects of DBS in patients with pharmacotherapy resistant depression. Since it is expected that such treatment approaches become more important in the future, the following article critically reviews the scientific background of both VNS and DBS, and providesa basis for further critical discussions.

Schlüsselwörter

Major Depression - Therapieresistenz - DBS - biophysikalische Verfahren

Keywords

Major Depression - resistance to therapy - DBS - biophysical methods

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