Electrical Stimulation Offers Hope for Depression Treatment

Electrode devices that stimulate nerves have emerged as a solution for patients with depression that do not respond to drug treatments, and there is competition among notable device companies to provide the most effective stimulator. These are the latest findings of Kalorama Information (New York, NY, USA), an independent market research firm.

There are several different device approaches to a potential stimulation treatment for depression, according to Kalorama Information study. Vagus nerve stimulation (VNS) uses an implanted stimulator that sends electric impulses to a nerve in the patient's neck, via a lead wire implanted under the skin. The VNS implantation devices consist of a titanium-encased generator about the size of a pocket watch, a wire system with electrodes, and an anchor tether to secure leads to the vagus nerve. Another, different, technology is repetitive transcranial magnetic stimulation (rTMS), which uses electrical pulses repeatedly passed through a coil placed on the scalp. The pulsating magnetic field generated by the coil penetrates the skull and disturbs the underlying neuronal equilibrium.

The leading products in these categories are the Cyberonics (Houston, TX, USA) VNS Therapy device and the Neuronetics (Malvern, PA, USA) NeuroStar TMS therapy system. However, other important companies in the device industry are looking to enter this market. Thus, Medtronic (Minneapolis, MN, USA) and St. Jude's Medical (Little Canada, MN, USA), which produce deep brain stimulation (DBS) systems currently used to treat Parkinson's and dystonia, are investigating adaptation of the systems to depression treatment. Boston Scientific (Natick, MA, USA), which produces a spinal cord stimulation system, is also reportedly developing depression treatment solutions. While continued research, testing, and approval cycles must be completed before new devices move to market, Kalorama Information sees a viable depression device treatment market in a five year time-frame, based on current developments.

"Depression treatment has made strides with modern pharmaceuticals, but there is a significant patient population that is refractory to treatment,” said analyst Mary Ann Crandall of Kalorama Information. "This should encourage regulatory agencies and insurance companies to become more receptive to newer approaches, which would further increase demand for these devices.”

Between 15 and 20 million people in the United States alone suffer from depression, corresponding to a potential market value of U.S. $16 billion annually for all cases of depression and a $4-5 billion potential market for drug refractory cases. Although the device route is limited by cost--which at the current time exceeds that of drug therapy--the cost differential could be reimbursed for providers through concomitant savings in antidepressant drug costs.

Related Links:
Kalorama Information
Cyberonics
Neuronetics