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pdoc wants me to add vns therapy to cocktail


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alrighty here is the pill schedule.....

whenI wake up I take

450 mg wellbutrin xl

200 mg provigal

300 mg effexor xr

about an hour later i take

30 mg metadate cd

300 mg lamictal

for evenings i have

klonopin as needed and ambian as needed

The doc finally diagnosed me as mixed state bp and adhd

now he wants to do vns therapy which appears to be a pacemaker that stimulates a nerve, and involves surgery.

Now i have always used the saying

" I'd rather have a bottle in front of me, than a frontal lobotimy inside of me"

so obviously i don't like the concept of surgery and psychiatry.

Also while researching it i noticed a couple of fda warnings to the company that makes it concerning manufacturing problems.

What do you peeps think.

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Well, although Vagal Nerve Stimulation is brand new I wouldn't think that it is particularly difficult from a technical perspective since the general procedures have been used for 30 years.

Install a pacemaker and lay the lead alongside the vagal nerve.

Nonetheless it is major surgery with the attendant risk.

That said, I would think that doing major surgery to treat a mental illness would be the very last resort, even after repeated ECT therapy.

What is your Pdoc saying about treatment alternatives?

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i too am weary of surgery.  if a med doesn't work, you can stop taking it.  i'm weary of ECT, but you can stop ECT... VNS and you need to have it removed. 

but the thing that would, personally, make me pause is that it is only FDA approved for treatment resistant depression, not for bipolar.

In this study there were bipolar patients in the group, though the majority were MDD.  of the bipolars in the study, 30% had induced mania.  (sorry, the link is to the abstract, i got that from the full text which i can't reprint here.)  personally, i would be weary of using something that had that high of a risk of inducing mania to treat mixed states.  but i'm not a doctor, and maybe there were better results in another study?  (though there really don't seem to be any studies on just bipolar and VNS...)

good luck with your decision. 


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VNS has been approved for severe refractory depression and epilepsy.

It was approved in 1997 for epilepsy and in 2005 for depression.

The thing I find interesting is that while it was made for public use in 1997, Cyberonics, Inc. did not receive the letter regarding its manufacturing practices [among a couple other things] until 2004.

It does help some people.

But since you are dx'd with BP mixed and adhd, I don't know that it would be appropriate for you, since that isn't the intended usage, bipolar can be very complex, and this isn't something that is easily changed.

There have been studies conducted for those with bipolar,though it is not approved.  And it is also said to be helpful in those with comorbid epilepsy and depression.

The FDA did approve it, so the company is now compliant, but I would still choose it as a very last resort, behind everything else possible.

It's a surgical procedure and once it is in there it is more difficult to remove than it was to implant.

And extensive article on vns and other treatments

Sorry I can't find more info right now.


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I would try ECT before I would consent to VNS. 

I would try another cocktail before I would try ECT.

I don't know that I am qualified to have an opinion, but my reaction to VNS is RUN, RUN like hell....

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