Neurosurgery for Depression

A range of effective treatments is available for major depressive disorder. Often, the first-line treatments are medication, talk therapy, or both. Many medication types are available, and medications usually take two to eight weeks to begin working. Several forms of talk therapy are also available, and these also take some time to reach their full effectiveness. Medication and talk therapy have been found to be particularly helpful together.

If the depression proves resistant to these interventions, non-invasive electrical stimulation techniques may help. Electroconvulsive therapy (ECT) is a highly effective treatment for depression that acts more quickly than medication and talk therapy; patients often see benefits within the first week of treatment. ECT is performed under general anesthesia, but it is not invasive. It uses small electric currents to stimulate the brain. A normal course of treatment may consist of up to 12 ECT sessions.

Transcranial magnetic stimulation (TMS) is another non-invasive form of stimulation. TMS uses a magnetic field to stimulate the brain. Patients remain awake during TMS, and treatments are usually delivered five days a week for four to six weeks.

Some patients still experience depression after these treatments. For these patients, neurosurgical options may be appropriate. There are several types of neurosurgery for depression, including vagus nerve stimulation, deep brain stimulation, and ablation.

Of the neurosurgical treatments for depression, vagus nerve stimulation and deep brain stimulation are adjustable and reversible.

Ablation involves rendering precise areas of dysfunctional brain tissue inactive, and it is not reversible.

The choice of procedure is based on many factors, including input from our multidisciplinary team of specialists and patient preference.