Table 1.
Comparison of devices for Treatment Resistant Depression (TRD). ECT : Electroconvulsive Therapy; TMS Transcranial Magnetic Stimulation; VNS : Vagal Nerve Stimulation, DBS; Deep Brain Stimulation
| ECT | TMS | VNS | DBS | |
|---|---|---|---|---|
|
FDA status |
“Gold standard” in TRD |
Approved for TRD after failure of one AD |
Approved |
Not approved – under investigation |
|
Reimbursed by insurance |
Yes |
Few cases |
No |
No |
|
Requires surgery/multidisciplinary team |
General anesthesia |
no |
Yes |
Yes |
|
Acute clinical efficacy |
yes |
yes |
No |
no |
|
Approximate costs (USD) |
10-15,000 for 3-4 weeks |
6-12,000 for 3-4 weeks |
40-45,000 for surgery + device |
200-250,000 for surgery + device |
| Follow-up adjustments / maintenance (per visit, USD) | 200-800 | 200-400 | 350-620 | 350-620 |