A pacemaker-like stimulator is placed by a surgeon under the skin of the chest wall under the left clavicle (collarbone) and programmed by our psychiatrist to send mild electrical signals along the left vagus nerve in the neck to the brainstem, and from here to certain areas of the brain that affect mood symptoms and can relieve symptoms of depression. VNS is not a rapid treatment for depression. While it may take several months for a treatment response to occur, whenever it's necessary, we can change the settings on the device (essentially changing the dose of the stimulation) in the office with a programming wand. Usually, the device is set to go off at regular intervals and one can also turn it off using a special magnet. Possible side effects from VNS include temporary hoarseness, cough, or shortness of breath, however such side effects usually only occur during the 30 seconds that the stimulator is on. Like any operation, the implantation procedure poses some risks, including infection, and as with pacemakers, eventually, one will need surgery to replace the battery when it wears out (7 to 8 years).
