Bipolar Today

A study published yesterday in the General Archives of Psychiatry showed a great deal of success for a method of treating depression called “Deep brain stimulation.” Deep brain stimulation uses a device that is similar to a pacemaker, but is used to introduce periodic currents into the brain. The study involved ten patients with major depressive disorder and seven patients with bipolar II. The first part of the trial was single-blinded, meaning that the patients didn’t know whether or not the device was switched on, but in the latter part, all patients received the treatment. After two years, eleven of the twelve people remaining in the trial showed improvement, providing a 92% response rate. The abstract of the study can be found here.

Commentary

Bipolar depression is notoriously hard to treat. Even if antidepressants were as effective in bipolar patients (they’re not), the risk of side effects, especially mania, are extremely high and difficult if not impossible to know in advance. As a result, patients, especially bipolar II patients, who suffer from depression often find it extremely debilitating. If a simple device analogous to a pacemaker can help treat bipolar depression, this would be extremely beneficial.

I am a supporter of electroconvulsive therapy in general, but it is worth noting that this treatment is less extreme than even modern ECT. In fact, they blinded the first part trial by not telling one group that the device was even on. In other words, once implanted, the device is so discreet that the user can’t even tell that it is working. Rather than returning constantly for more treatment, it allows the patient to simply go on with his or her life.

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