Long-Term Outcome of Vagus Nerve Stimulation in Rapid-Cycling Bipolar Disorder

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Sir: The phenomenon of rapid cycling in patients with bipolar disorder has been identified as a marker for high risk of recurrence and resistance to conventional drug treatment.1 New anticonvulsants are promising agents for the treatment of bipolar disorders, but they are heterogeneous with regard to their efficacy, target symptoms, and adverse event profiles.2

Vagus nerve stimulation (VNS) therapy is delivered with a device (NCP System; Cyberonics, Houston, Tex.) and has received U.S. Food and Drug Administration approval for adjunctive long-term treatment of chronic or recurrent depression for patients who are experiencing a major depressive episode and have not had an adequate response to 4 or more adequate antidepressant treatments.​

J Clin Psychiatry 2006;67(5):837-838