Interventions
Deep Brain Stimulation (DBS)
Deep brain stimulation implants electrodes into specific deep brain structures and delivers continuous high-frequency stimulation to modulate a dysfunctional circuit. It is the most invasive and most precisely targeted intervention in psychiatry, investigational for depression and approved under humanitarian exemption for refractory OCD.
7 min readElectroconvulsive Therapy (ECT)
Electroconvulsive therapy uses a brief, controlled seizure induced under general anesthesia to treat severe depression. It is the single most effective acute treatment for severe, psychotic, and catatonic depression.
6 min readFocused Ultrasound and Ablative Neurosurgery
This covers deliberately destroying a small volume of brain tissue to interrupt a pathological circuit (ablative neurosurgery), the incisionless technology that increasingly performs it (MR-guided focused ultrasound), and the emerging frontier of reversible, non-invasive deep-brain modulation with low-intensity focused ultrasound.
9 min readInterventional and Neurostimulation Psychiatry (Overview)
An overview of the device- and procedure-based treatments for depression, organized along a gradient of invasiveness, precision, and evidence. It explains how these seemingly disparate modalities converge on the same brain circuitry and the same cellular endpoint.
6 min readTranscranial Direct Current Stimulation (tDCS)
Transcranial direct current stimulation passes a weak constant current between scalp electrodes to gently shift the excitability of underlying cortex. It is the cheapest, most portable, and least invasive neurostimulation method, with modest efficacy but a growing case for supervised home use.
7 min readTranscranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation uses a magnetic coil held against the scalp to stimulate the prefrontal cortex without anesthesia or cognitive side effects. It is the most widely used device-based treatment in psychiatry, with moderate efficacy in treatment-resistant depression.
9 min readVagus Nerve Stimulation (VNS)
Vagus nerve stimulation is an implanted, adjunctive neuromodulation therapy for markedly treatment-resistant depression that delivers intermittent electrical stimulation to the left vagus nerve. Its benefit is slow, cumulative, and durable, which makes it genuinely difficult to demonstrate in acute controlled trials.