Concomitant use of vagus nerve stimulation and electroconvulsive therapy for treatment-resistant depression

Michael J. Burke, Mustafa M. Husain

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


OBJECTIVE: This study explored the use of electroconvulsive therapy (ECT) in the pivotal study of vagus nerve stimulation (VNS) for treatment-resistant depression. METHODS: The clinical characteristics and outcomes of study participants who received ECT during the first 12 months of VNS were compared with those who did not receive ECT. Physicians were instructed to turn off VNS during administration of ECT. RESULTS: Of 205 (evaluable sample) patients who received VNS, 14 also received ECT. Participants who received ECT had a statistically significant greater number of hospital admissions (P = 0.037, Wilcoxon) and number of suicide attempts during their lifetimes (P= 0.022, Fisher exact test). Of 55 responders (≥50% reduction in Hamilton Rating Scale for Depression-24 questions [HRSD-24] scores) after 12 months of VNS, 3 had received ECT. Of 32 remitters (HRSD-24 score, ≤9), 2 had received ECT. Administration of ECT did not affect the implanted VNS device, and the presence of the implanted VNS device did not affect the administration of ECT. CONCLUSIONS: Electroconvulsive therapy and VNS are not mutually exclusive. They can be used safely and effectively either sequentially or concurrently. Each can be prescribed as the depressive condition warrants-ECT for emergently worsening depressive symptoms and maintenance therapy and VNS for chronic, long-term therapy.

Original languageEnglish (US)
Pages (from-to)218-222
Number of pages5
JournalJournal of ECT
Issue number3
StatePublished - Sep 2006


  • Antidepressant treatment
  • Brain stimulation
  • Depression
  • Electroconvulsive therapy
  • Major depressive disorder
  • Treatment-resistant depression
  • Vagus nerve stimulation

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health


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