Evidence-based recommendations on vagus nerve stimulation for treatment-resistant depression. This involves a generator being implanted under the skin in the chest area to provide electrical stimulation to the nerve.
Is this guidance up to date?
We checked this guidance in January 2020 and we are updating it. See the guideline in development page for progress on the update.
Guidance development process
A33.1 Introduction of neurostimulator into cranial nerve
Z04.4 Vagus nerve (x)
In addition an ICD-10 code from category F32 Depressive episode or F33 Recurrent depressive disorder is assigned.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.