{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:40:05Z","timestamp":1794030005262,"version":"4.8.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2008,1,4]],"date-time":"2008-01-04T00:00:00Z","timestamp":1199404800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:sec id=\"S0033291707001924_sec_a001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291707001924_sec_a002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291707001924_sec_a003\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (\u2a7e50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score &lt;10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset; 44% of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63% at 3 months of stimulation) and coughing (23%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291707001924_sec_a004\" sec-type=\"conclusion\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VNS therapy was effective in reducing severity of depression; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291707001924","type":"journal-article","created":{"date-parts":[[2008,1,4]],"date-time":"2008-01-04T09:49:27Z","timestamp":1199440167000},"page":"651-661","source":"Crossref","is-referenced-by-count":173,"title":["Vagus nerve stimulation for depression: efficacy and safety in a European 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