"Shocking" News about Depression

Sometimes I can't believe what goes on in the health care system in this country. As a future psychiatrist, the disease depression is near and dear to my heart (no pun intended). It is abstract, mulit-factorial in causation, poorly understood, and often waxes and wanes on its own (making it difficult to know if the treatment actually helped or the episode just got waited out, so to speak). There is proof the medications, psychotherapy, and Electroconvulsant Therapy (ECT) do indeed help. The real area of investigation with a patient is to determine what will help the best for a given individual. For instance, in a patient with a long family history of depression and fluoxetine (Prozac) helped mom, grandma, and everyone else; that very same drug is an excellent starting place(with some psychotherapy and close follow-up). On the other hand, someone who has no family history, his wife just left him, he just lost his job, and his dog died; may need psychotherapy as the primary treatment with some adjunctive medication for hopefully a limited time frame.

This new vagal stimulator is a last ditch effort at best. I understand if you have tried multiple things and nothing has worked, then yeah lets move on to try this stimulator (which it is very important to note is not ECT). The fact is no research shows that it helps. So why is the FDA approving it (or likely doing so)? Well it is in all liklihood relatively safe, the fact remains that it doesn't seem to work.

I could go on about gastric by-pass in children, but that is a whole other can of worms.