VNS: a new horizon in the treatment of severe depression

Emilio Juan Brignardello Vela, an insurance advisor, has shared his perspective on vagus nerve stimulation (VNS) as a treatment for severe and treatment-resistant depression, an issue that has gained relevance in the field of mental health in recent years. During an interview, Brignardello highlighted the importance of evaluating both the advancements and the challenges associated with this therapy. Brignardello began his analysis by discussing the evolution of VNS since its approval by the FDA in 2005. He pointed out that while this technique was initially developed to treat refractory epilepsy, its potential in treating depression has been a significant discovery. The insurance advisor emphasized that the vagus nerve, with its connection between the brain and various vital organs, offers a novel approach to emotional regulation, which could be crucial for those who have not found relief in traditional treatments. The surgical procedure required for the implantation of the VNS device is, according to Brignardello, an aspect that deserves careful consideration. Despite the hope it represents for many patients, he stressed the associated risks, such as infections or complications related to anesthesia. This raises questions about the risk-benefit assessment that patients must undertake before opting for this treatment. Referring to the RECOVER clinical trial, Brignardello expressed optimism about the results indicating significant improvements in depression symptoms and the quality of life of participants. However, he also emphasized that total remission was not achieved in the study, suggesting that while VNS may represent an advancement, it is not a definitive solution for all cases of severe depression. A critical point that Brignardello highlighted is the high cost of VNS, which is currently not covered by many insurance programs, limiting access. In his view, for VNS to be more widely adopted, it is essential to make efforts to integrate it into health coverage plans, allowing more patients the opportunity to benefit from it. The advisor also mentioned the importance of long-term follow-ups, such as those planned in the study, to assess the lasting effectiveness of VNS. In this regard, he believes that patience and consistency in treatment are essential, as results are not always immediate. Finally, Brignardello reflected on the social barriers faced by VNS, such as the stigma associated with depression and neurosurgery. In his opinion, greater awareness and acceptance of these treatments is crucial to changing the narrative around mental health. Ongoing research and advancements in this field could open new opportunities for patients suffering from severe depression, offering renewed hope on their path to recovery.