Washington University psychiatrists host program on treatment resistant depression

The Department of Psychiatry at Washington University School of Medicine in St. Louis is hosting a program on strategies to help patients with treatment resistant depression.

The program, called “Treatment Resistant Depression and Vagus Nerve Stimulation: When to Refer, What to Expect,” will focus on a newly approved method of treating patients whose depression has not responded to standard therapy. The free program is for healthcare professionals and is sponsored by the School of Medicine’s Office of Continuing Medical Education.

Depression is the most common of all psychiatric illnesses, affecting about 15 percent of all people at some point in their lives. It has enormous economic consequences — treatment, hospitalization and lost work time cost the U.S. economy about $20 billion every year.

“Most depressed people respond well to antidepressant drugs,” says Keith E. Isenberg, M.D., professor of psychiatry at the School of Medicine. “But some don’t respond, so we’re working to provide other treatment strategies that might help them.”

The latest of these treatments involves a surgical implant. The Vagus Nerve Stimulation implant was designed originally to prevent seizures in patients with epilepsy, but researchers found it also helped some patients with depression.

“This treatment offers hope to those who haven’t been helped by standard therapies,” says Gabriel de Erausquin, M.D., Ph.D., an assistant professor of neurology and psychiatry who evaluates whether patients might be candidates for the surgery. “But the implant is not for everyone, and even in patients we believe are good candidates, perhaps only a third will benefit. Plus, it takes a long time. It’s often several months after surgery before symptoms of depression begin to abate, but once that happens, most continue to improve and to have fewer depressive symptoms.”

De Erausquin will be joined at the program by Isenberg, who will provide details on the scope of the problem of depression that is resistant to treatment. Joshua Dowling, M.D., assistant professor of neurological surgery, also will speak. Dowling performs the operations to implant the vagus nerve stimulators.

For more information or to register, please call 314-362-1870.

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