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
From: Somatic therapies for treatment-resistant depression: ECT, TMS, VNS, DBS
| 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 |