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February 5, 2005

BehindTheMedspeak: Invasive Psychiatry


You've never heard the term before because I just invented it.

But I don't have the time or interest required to trademark or patent or copyright it or whatever one does with a term.


Shrinkette, take it from here, would you?

You keep all the cash: I take no commission.

The term's gonna come into vogue real soon, because the F.D.A.'s on the verge of approving the use of Cyberonics' implantable vagal nerve stimulator for the treatment of depression.

Currently used in Europe for the treatment of seizures, the device, which costs $15,000, acts as a sort of pacemaker for the brain.


It's the size of a pocket watch and must be surgically implanted in the upper chest, then connected via thin wires to the vagus nerves in the neck.

It then sends pulses through the nerves into parts of the brain associated with depression.

Total cost for the device plus the surgical procedure is around $20,000.

Hey, stop, what's that sound?

Oh, yeah: "ka-ching."


Cyberonics estimates that 4.4. million Americans suffer from the severe and recurring type of depression that might be treated with its device, called the VNS [Vagal Nerve Stimulator] Pulse 102.

That's a lot of "ka-ching."

Robert P. Cummins, the chairman, CEO, and president of the company said in yesterday's New York Times story that "If it is adopted for depression at the same rate as it has been for epilepsy, we will pass $1 billion in sales by 2010."


Hey, you with the band, strike up "We're In The Money."

Here's what I don't understand: how is it, with all the wireless technology that's sweeping into wide use, both cardiac and now central nervous system pacemakers still rely on old-fashioned hard-wired technology requiring expensive, invasive surgical procedures, with all the complications that accompany such things?

Bleeding, infection, all manner of things happen when you go in surgically.

So why aren't these devices able to be worn outside the body, or at least inserted via a transcutaneous technique akin to that used for birth control with Norplant?

The signals could then be sent wirelessly to the heart or brain.

Couldn't be the juicy $5,000 fee the surgeon gets for the 15-minute implantation procedure, could it?

Nah - how could I think that?

If you've ever had any contact with depression - in yourself, a loved one, or a friend - you could not do any larger favor for the both of you than to buy and read William Styron's brief, overpoweringly affecting memoir of his own descent into a hell worse than any imaginable.


It's entitled - perfectly aptly, in my opinion - "Darkness Visible: A Memoir of Madness."

February 5, 2005 at 10:01 AM | Permalink


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Make fun of it if you will but if it can replace EST and insurance will pay for it the way they do pacemakers let's go for it.

Posted by: ScienceChic | Feb 6, 2005 6:01:14 PM

I'm with Joe on this. I'd like to have something I could wear on my belt. Then, when I feel bad, I could just push a button and feel better. Sign me up!

Posted by: shrinkette | Feb 5, 2005 12:49:38 PM

Stanford (and I believe other centers) are testing an electomagnetic pulse through the brain for the treatment of drug-resistant depression. I believe such treatment is widely used in Australia.

I believe the current protocol is 6 weeks of daily (M-F) treatment.

Posted by: liz | Feb 5, 2005 11:49:47 AM

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