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Published Online: 2 December 2021

Neuromodulation Strategies for the Treatment of Depression

Abstract

For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of medications and a psychological paradigm resulting in the development of psychotherapies. A third paradigm positing that psychiatric dysfunction results from abnormal communication within a network of brain regions that regulate mood, thought, and behavior has gained increased attention over the past several years and underlies the development of multiple neuromodulation and neurostimulation therapies. This neural circuit paradigm is not new. In the late 19th and early 20th centuries, it was a common way of understanding psychiatric illness and led to several of our earliest somatic therapies. However, with the rise of effective medications and evidence-based psychotherapies, this paradigm went mostly dormant. Its recent reemergence resulted from a growing recognition that medications and psychotherapy leave many patients inadequately treated, along with technological advances that have revolutionized our ability to understand and modulate the neural circuitry involved in psychiatric disorders. In this overview, the authors review the history and current state of neuromodulation for psychiatric illness and specifically focus on these approaches as a treatment for depression, as this has been the primary indication for these interventions over time.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 1082 - 1088

History

Accepted: 19 October 2021
Published in print: December 2021
Published online: 2 December 2021

Keywords

  1. Neurostimulation
  2. Depressive Disorders
  3. Neurostimulation
  4. ECT
  5. Neurostimulation
  6. Vagus Nerve Stimulation

Authors

Details

Susan K. Conroy, M.D., Ph.D.
Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy);National Center for PTSD, Executive Division, White River Junction VA Medical Center, White River Junction, Vt. (Holtzheimer);Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Lebanon, N.H. (Holtzheimer).
Paul E. Holtzheimer, M.D. [email protected]
Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy);National Center for PTSD, Executive Division, White River Junction VA Medical Center, White River Junction, Vt. (Holtzheimer);Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Lebanon, N.H. (Holtzheimer).

Notes

Send correspondence to Dr. Holtzheimer ([email protected]).

Competing Interests

Dr. Holtzheimer has served as a consultant for Abbott and receives royalties from UpToDate and Oxford University Press. Dr. Conroy reports no financial relationships with commercial interests.

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