Alternative Approaches to Treating Deep Depression

The psychiatric disturbances associated with seizure disorders often originate in a deep, difficult to treat depression. A pharmacological treatment using antidepressants is usually the first step in dealing with the depression. This section discusses some alternative forms of treatment. The physician needs to be consulted before considering any of the alternative approaches.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is normally used in severely depressed patients for whom psychotherapy and medication have not been effective. The basic premise of the treatment is that ECT acts by temporarily altering some of the brain’s electrochemical processes. Dramatic improvements in alleviating depression often occurs, but with a potential side effect of memory loss. ECT is considered the most effective approach in dealing with deep depression.

The procedure is usually performed in a hospital. An intraveneous (IV) is inserted to provide anaesthetic medication. Vital signs are taken initially and continuously through the procedure. An anesthesiologist administers anesthesia and places a tube in the throat after the patient is asleep. A paralyzing agent called succinylcholine is then administered to present the seizure from spreading to the body. Electrodes are then applied to the head with conducting jelly and a brief shock (less than 2 seconds) is administered. A grand mal seizure is produced. As the patient wakes, there may be headache, nausea, temporary confusion and muscle stiffness. There can be a loss in the short-term memory, but this usually clears up with time.

A single treatment can be effective. However, the original depressive condition may return and periodic treatments may be required.

Additional information can be obtained at:

Magnetic Seizure Therapy

A new method for treating deep depression is magnetic seizure therapy. This method uses high intensity repetitive transcranial magnetic stimulation to induce focal seizures from targeted portions of the brain. The treatment is performed in a setting similar to that used for ECT. The major advantage of magnetic seizure therapy is that it produces the same benefits of ECT without a lot of the side effects. There is much less concern about amnesia since less electricity is used and the seizure is limited to targeted areas.

Magnetic seizure therapy is still in a development stage and there are relatively few locations where the equipment and technology are available. The consensus, however, seems to be that this technology holds a lot of promise and will be commonly available within the next few years.

Additional information can be obtained at:

Vagus Nerve Stimulation

Vagus nerve stimulation (VNS) has been used for suppression of seizures and for the treatment of deep depression. The VNS device is sometimes referred to as “pacemaker for the brain”. It is placed under the skin on the chest wall and a wire runs from it to the vagus nerve in the neck. The vagus nerve is part of the autonomic nervous system, which controls functions of the body that are not under voluntary control (e.g., heart rate). Surgery is required to implant a flat, round battery about the size of a silver dollar.

The VNS device is programmed to periodically provide a pulse to the vagas nerve. The device typically provides 30 seconds of stimulation followed by 5 minutes of no stimulation.

Additional information about vagus nerve stimulation can be found at:

Dr. Blumer (2000) indicates that severe psychiatric complications can occur by treatments that eliminate or greatly reduce seizures. He specifically cited a study showing that 9% of those treated with vagus stimulation had worsened psychiatric symptoms. We are also aware of a recent blotched VNS surgery that resulted in the severing of one of the vocal cords. Based upon these citations, we would consider vagus nerve stimulation to have low potential for treatment of seizure-related psychiatric disturbances.


Research at Stanford University has indicated that a high percentage of those dealing with psychotic depression have high and disordered patterns of cortisol. Cortisol is a hormone produced by the adrenal gland that plays a role in the way the body reacts to stressful situations. Their research has shown promising results with Mifepristone, commonly known as the RU-486 abortion pill. The preliminary research shows that Milepristone can dramatically improve symptoms within days, resulting in a greatly reduced need for antidepressants.

This product is now undergoing research trials by a company by the name of Corcept to evaluate the product. If successful, it will eventually be made available to the public.

Additional information about the use of Mifepristone for psychotic depression can be found at:

Our studies indicate that various natural products (e.g. Relora) and Remeron are effective in lowering cortisol levels. It is not known if such products are helpful in dealing with psychotic depression. A brief description of the research findings on Remeron may be found at: