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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