MyDepressionSpace.com

Only twenty-seven patients were implanted with the VNS Therapy System(TM) for TRD during the past 90-days.

We are now entering the fourth year of FDA's final approval of vagus nerve stimulation to treat major depressive disorder. Cyberonics, the manufacturer of the vagus nerve stimulator continues to execute on its previously announced plan to focus primarily on the epilepsy market.

From February 22nd 2008 to April 25th, a total of twenty-seven patients in the United States were implanted with the VNS Therapy System^TM for depression. That is about one patient for every two states. Cyberonics continues to seek a financial partner or joint venture for a new depression clinical study.

Unfortunately, I think that universal reimbursement for non-pharmacological based treatments (excluding ECT and psychotherapy) such as VNS, TMS, FEAST, and DBS is many years away. Below is a painful reminder of Medicare's National Coverage Determination for vagus nerve stimulation (VNS):

"CMS (Centers for Medicare and Medicaid Services) believes almost all correctly identified depressed patients can be successfully treated for depression" [HELLO?]

"CMS has determined that there is sufficient evidence to conclude that vagus nerve stimulation is not reasonable and necessary for treatment of resistant depression. Accordingly, we are issuing the following national coverage determination:

Vagus nerve stimulation is not covered for treatment resistant depression."*

Debt, mortgage foreclosures and depression; mother commits suicide just prior to bank foreclosure

This is a very sad story which affects the entire family of a mother who committed suicide; the husband, her parents, the children and so on. Today in Taunton, Massachusetts a 53-year-old wife and mother fatally shot herself soon after faxing a letter to her mortgage company saying that by the time they foreclosed on her house that day, she would be dead:

Police in Taunton said Carlene Balderrama used her husband's high-powered rifle to kill herself Tuesday afternoon, after faxing the letter at 2:30 p.m. The mortgage company called police, who found Balderrama's body at 3:30 p.m. in her brown-shingled raised ranch house. The auction was scheduled to start at 5 p.m. and interested buyers arrived at the property in Taunton, about 35 miles south of Boston, while Balderrama's body was still inside, according to the chief of police.

Just reading about this shocking tragedy sent shivers down by spine. The police also said a suicide note found next to Balderrama told her husband, John, and 24-year-old son to "take the (life) insurance money and pay for the house." A friend who works with Balderrama's husband, a plumber, said Balderrama handled the bills and her husband didn't know about the foreclosure.

"John didn't even know about it, that's the surprise," the friend told The Boston Globe. "It's just one of those awful, awful tragic events." Neighbors on this forested side street said the family had lived in the two-story, brown-shingled, raised ranch for about four years.

Noreen Mendes, who lived about four houses down the street from Balderrama, said she often stopped and chatted with her. Mendes said Balderrama never mentioned any financial problems, but often spoke about repairs the family was making to their house. Two weeks ago, a contractor came to the house to give Balderrma an estimate on a roof replacement, Mendes said.

"She was just so sweet, so nice. I never realized she had any problems, so it is just shocking," Mendes said.

Most people hide their financial problems. Suicide victims are very good at  hiding  their  plans to attempt suicide. Debt and financial stress can cause or increase depression. Sometimes it can be fatal. Suicide is a permanent solution to a temporary problem. Just as tragic, life insurance policies do not pay for death by suicide. This house will be never be the same:

Diabetes contributes to depression and depression patients are at higher risk for diabetes.

Depression patients are at a substantially higher risk of developing diabetes than the general population. Yet the potential co-morbidity disease of diabetes is often not considered as a serious illness. According to yesterday's New Tork Times, the consensus amongst the patient population is that "there's medication to take care of this illness.

But diabetes is anything but minor. It wreaks havoc on the entire body, affecting everything from hearing and vision to sexual function, mental health and sleep. It is the leading cause of blindness, amputations and kidney failure, and it can triple the risk for heart attack and stroke.

It is a disease that does have the ability to eat you alive,” said Dr. John B. Buse, a professor at the University of North Carolina School of Medicine who is the diabetes association’s president for medicine and science. “It can be just awful — it’s almost unimaginable how bad it can be.” Diabetes results when the body cannot use blood sugar as energy, either because it has too little insulin or because it cannot use insulin. Type 2 diabetes, which accounts for 90 to 95 percent of cases, typically develops later in life and is associated with obesity and lack of exercise. Type 1 diabetes, which is often diagnosed in children, occurs when the immune system mistakenly destroys cells that make the insulin.

.And to make matters worse, diabetes is associated with numerous other health problems. Last week, for example, The Journal of the American Medical Association reported that people with depression were at higher risk for Type 2 diabetes, and vice versa.

That is not surprising: according to data published last year in the journal Diabetes Care, depression tends to interfere with a patient’s self-care, which requires glucose monitoring, medications, dietary changes and exercise.

Ultimately, diabetes can take a toll from head to toe. In the brain, it raises the risk not only for depression but also for sleep problems and stroke. It endangers vision and dental health. This month, The Annals of Internal Medicine is reporting that the disease more than doubles the risk of hearing loss.

Diabetes can also take a toll on relationships. By some estimates, 50 percent to 80 percent of men with diabetes suffer from erectile dysfunction. Experts say women with diabetes often lose their libidos or suffer from vaginal dryness. This is in addition to sexual dysfunction( anorgasma) cause by antidepressants such as Lexapro.

COMMENT: This new strategy is not a scare tactic. Prevention and hope will still be part of the message.