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To millions of people worldwide, deep depression is a way of life; not that they have chosen it, but that it has chosen them. Although short-term depression can be cured through a regime of antidepressants or psychotherapy, deep depression cannot. It lasts for years, often the person's lifetime, and is resistant to all forms of conventional theory. People who suffer from deep depression have typically given up hope of ever being cured; they live their lives in various stages of agony; constantly depressed, often feeling alone and frightened, and always at high risk for suicide.
People in deep depression need a break, and a revolutionary and potentially effective treatment is being suggested after a very small trial of six people proved somewhat effective. This very small clinical trial is soon to be followed by a much larger clinical trial, and offers hope of a major advance in the development of effective treatment for deep depression.
For the first time, perhaps the scientific community has hit upon a procedure that will allow skillful surgeons to curb this devastating disease, and offer patients relief from the symptoms of deep depression that has, until now, not been possible. The procedure is known as deep brain stimulation (DBS), and it has been successfully used for decades to treat intractable pain, and is now being considered for the treatment of epilepsy and other debilitating neurological conditions. The FDA has recently approved it to treat Parkinson's disease.
But it is because of its success in clinical trials with people suffering from obsessive compulsive disorder that it came to be considered as a possible treatment for deep depression. Clinical trials showed that it not only significantly reduced the anxiety and obsessions common to patients with obsessive compulsive disorder, but that it also reduced their co-morbid depression; that is, the depression spurred by having a chronic physical illness. This led researchers to want to pursue it as a tool in the treatment of deep depression.
Deep brain stimulation is possible through a neurosurgical procedure where tiny electrodes are implanted into specific parts of the brain that are functioning abnormally. From these tiny electrodes, tiny pulses of electrical stimulation are sent to the brain, blocking the source of the abnormal activity and offering relief from symptoms such as pain, tremors, anxieties, obsessions, or the depression associated with various psychiatric or physical disorders. This surgery is reversible, nondestructive and can be modified by adjustment of the stimulator setting after implantation.
Only a tiny study has yet been completed to gage its usefulness in the treatment of deep depression, but researchers from the Cleveland Clinic and Brown University's Butler Hospital, who conducted the trial, feel that deep brain stimulation may prove to be both an effective and revolutionary treatment for the disease.
The trial, which took place between 2003 and 2005, consisted of six patients with an average age of 48, all of whom had been highly resistant to other treatments for depression, including medication, psychotherapy and electroconvulsive therapy. At six months four of participants showed a clinically significant reduction in depression, while two of them did not. The patients who did receive relief also experienced progressive improvements in mood and function over the time studied.
Certainly such a small-scale study offers little conclusive proof, but it was promising enough to lead Medtronic, Inc., a maker of the deep brain stimulation equipment, to announce plans for the development of a major clinical trial. In the coming months, Medtronic's senior vice president, Dr. Richard E. Kuntz, M.D., said the company plans for teams of leading neurosurgeons and psychiatrists to design a major clinical trial, which will meet the rigors of FDA approval, to use deep brain stimulation to treat deep depression in people who have not responded to conventional treatment. To date, more than 30,000 people have used Medtronic's deep brain stimulation equipment for conditions other than deep depression.
