{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:37:49Z","timestamp":1773920269056,"version":"3.50.1"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"\n Background<\/jats:title>\n Vagus nerve stimulation (VNS) is a well-established treatment option for treatment-resistant affective disorders. Due to potential concerns about increased cardiac innervation on the right side, devices are almost exclusively implanted on the left cervical vagus nerve. Clinical data on right-sided VNS for psychiatric indications are often very scarce.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We present a case series involving three patients\u2014two with MDD and one with bipolar depression\u2014each with extensive prior unsuccessful treatments, frequent hospitalizations, and severe psychiatric and medical comorbidities. In each case, the right cervical side was chosen for primary implantation or re-implantation due to cardiac disease, pre-existing devices, or anatomical constraints (including high-grade atrioventricular block with pacemaker and recurrent laryngeal nerve palsy). All patients underwent standard titration of stimulation parameters and long-term clinical follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n All three patients showed significant and lasting mood stabilization within approximately 12 months after right-sided VNS implantation. Hospital admission rates decreased markedly, and in two cases, maintenance electroconvulsive therapy (ECT) was discontinued or notably reduced. In all cases, VNS was generally well tolerated. During right-sided stimulation, no clinically significant bradyarrhythmia, device interactions, or other serious cardiac adverse events were observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This series highlights the usefulness of right-sided VNS in sustaining long-term mood stability and reducing hospitalizations for patients with highly treatment-resistant, comorbid mood disorders. The findings expand existing epilepsy-focused data on right-sided VNS to the psychiatric field and support systematic evaluation of this approach in future prospective studies. Multidisciplinary coordination is essential to minimize risks and improve outcomes. Additional long-term research is needed to assess its lasting effectiveness, optimal candidate selection, and cost-efficiency in routine clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1754397","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:50:23Z","timestamp":1773903023000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Right\u2212sided vagus nerve stimulation for treatment\u2212resistant affective disorders with complex cardiac comorbidity"],"prefix":"10.3389","volume":"17","author":[{"given":"Christiane","family":"Licht","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Rheinisch-Westf\u00e4lische Technische Hochschule (RWTH) University Clinic","place":["Aachen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Landgrebe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University of Regensburg","place":["Regensburg, Germany"]},{"name":"Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied","place":["Hausham, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Pieper","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Clinic Wilhelmshaven","place":["Wilhelmshaven, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-024-07444-y","article-title":"Global prevalence of major depressive disorder, generalized anxiety, stress, and depression among infertile women: a systematic review and meta-analysis","volume":"309","author":"Salari","year":"2024","journal-title":"Arch Gynecol Obstet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"120483","DOI":"10.1016\/j.jad.2025.120483","article-title":"Long-term efficacy and safety of vagus nerve stimulation in treatment-resistant depression: A systematic review","volume":"394","author":"Rosson","year":"2025","journal-title":"J Affect Disord"},{"key":"B3","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.brs.2024.12.1187","article-title":"Effects of vagus nerve stimulation on daily function and quality of life in markedly treatment-resistant major depression: Findings from a one-year, randomized, sham-controlled trial","volume":"18","author":"Rush","year":"2025","journal-title":"Brain Stimul"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000724","article-title":"Vagus nerve stimulation in patients receiving maintenance therapy with electroconvulsive therapy: A series of 10 cases","volume":"37","author":"Aaronson","year":"2021","journal-title":"J ECT"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52312","article-title":"Right\u2010sided vagus nerve stimulation: Worldwide collection and perspectives","volume":"12","author":"Zanello","year":"2025","journal-title":"Ann Clin Transl Neurol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2025.1609654","article-title":"Left and right vagus nerve stimulation: historical perspectives, clinical efficacy, and future directions","volume":"19","author":"Sharma","year":"2025","journal-title":"Front Hum Neurosci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00064","article-title":"Vagus nerve stimulation for depression: A systematic review","volume":"10","author":"Lv","year":"2019","journal-title":"Front Psychol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2019.152156","article-title":"Vagus nerve stimulation (VNS) therapy in patients with treatment resistant depression: A systematic review and meta-analysis","volume":"98","author":"Bottomley","year":"2020","journal-title":"Compr Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2013.149","article-title":"Relapse following successful electroconvulsive therapy for major depression: A meta-analysis","volume":"38","author":"Jelovac","year":"2013","journal-title":"Neuropsychopharmacol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1177\/0004867417743343","article-title":"Electroconvulsive therapy in the continuation and maintenance treatment of depression: Systematic review and meta-analyses","volume":"52","author":"Elias","year":"2018","journal-title":"Aust N Z J Psychiatry"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1754397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:50:24Z","timestamp":1773903024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1754397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":10,"alternative-id":["10.3389\/fpsyt.2026.1754397"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1754397","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]},"article-number":"1754397"}}