What Is Transcutaneous Vagus Nerve Stimulation and Is It for Me?

tVNS is a form of electrical stimulation that sends mild pulses through the skin to activate the vagus nerve and brain. This emerging treatment may offer relief for your depression.

Research into understanding depression and other mental health conditions also spurs the development of new treatment methods.

Transcutaneous vagus nerve stimulation (tVNS) is one emerging treatment for depression that’s still being studied. This noninvasive method sends low frequency electrical currents through the skin to stimulate the vagus nerve, potentially easing depression symptoms.

Let’s break down what tVNS is, if it can offer depression relief, how it may work, and if it’s currently available.

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What is transcutaneous vagus nerve stimulation?

Transcutaneous vagus nerve stimulation (tVNS) is a form of transcutaneous electrical nerve stimulation (TENS). In the United States, TENS and tVNS are currently used to help manage pain from chronic pain conditions like migraine, endometriosis, and arthritis.

TENS devices send a set, low frequency electrical pulse through the skin for short durations, usually a few seconds at a time. These pulses travel through sticky electrodes placed on specific parts of the body, passing through the skin — without piercing it — to activate nerves and neurotransmitters.

TENS treatment with tVNS targets the vagus nerve, a nerve pair that makes up one of the body’s twelve cranial nerves.

The vagus nerve runs down either side of the body from your brain to your large intestine and helps regulate functions like:

• digestion
• heart rate
• inflammation
• immune response
• mood

tVNS devices generally stimulate the vagus nerve through either the ear (transcutaneous auricular VNS, or taVNS) or the neck (transcutaneous cervical VNS, or tcVNS).

tVNS has relatively few side effects. While some people may not experience any, side effects that can occur include:

• sleepiness
• sensations of tingling or prickling (paresthesia) at the electrode site
• itching at or around the electrodes
• tinnitus (ringing in the ears)
• headache

Side effects generally go away shortly after treatment.

Can vagus nerve stimulation help treat depression?

Transcutaneous methods may be a more recent invention, but targeting the vagus nerve for depression treatment isn’t a new idea — it was actually developed a few decades ago.

Vagus nerve stimulation (VNS) is a depression treatment in which a VNS device is surgically implanted under the skin on the left side of the chest, just below the clavicle. The implanted device sends electrical currents along the vagus nerve to areas of the brain that control mood.

Research has shown surgical VNS to be effective for treatment-resistant depression (and epilepsy). However, it’s an invasive method that’s generally only used after no other treatment strategies have worked.

Transcutaneous VNS, on the other hand, is thought to be an alternative way to access the vagus nerve and trigger similar areas in the brain. tVNS may offer a noninvasive, convenient, and home-based treatment option for depression.

Can tVNS help treat depression?

Research into tVNS for use in mental health care, including depression treatment, is ongoing. Though the treatment is still in the early stages of development, it has shown promise.

First, let’s look at taVNS (vagus nerve stimulation on the ear), which has been more widely studied than tcVNS (stimulation on the neck).

In a 2016 study, participants with mild or moderate major depressive disorder (MDD) self-administered taVNS treatment at home. The study found that taVNS effectively reduced symptoms of depression compared to placebo. Positive effects continued throughout the 12-week treatment period. 

A more recent 2022 study compared MDD treatment with taVNS versus the antidepressant citalopram (Celexa). Treatment with taVNS provided symptom improvement similar to antidepressant relief. Participants using taVNS also had higher rates of remission at both 4 and 6 weeks into treatment.

More generally, a 2018 research review reports that taVNS is safe and well tolerated.

Treatment may effectively ease depression symptoms, including anxiety, sleep disturbance, and hopelessness. However, the authors emphasize the need for more research in order to better understand and optimize taVNS treatment.

A 2023 research review is more reserved. It underlines that, although taVNS is safe and certainly shows promise, there isn’t yet enough information to recommend it for depression treatment. Since taVNS is a new method, the authors call for more rigorous clinical studies to show whether it’s effective. 

As for tcVNS, clinical research largely centers around post-traumatic stress disorder (PTSD). Multiple studies, like this 2021 study, have shown that stimulating the vagus nerve in the neck effectively reduces symptoms of PTSD, including anxiety.

How does tVNS help treat depression?

It’s not yet clear what, exactly, is behind any potential effects tVNS may have on depression. (Scientists are still trying to figure out how surgical VNS helps depression, too.) Multiple mechanisms likely play a role.

According to common theories, tVNS may help depression by:

• Activating mood regulation: The vagus nerve gives information to areas of the brain involved in controlling emotion. tVNS may help regulate your mood and depression by activating those areas.
• Decreasing inflammation: Depression may be related to chronically higher levels of certain inflammation-causing chemicals. tVNS may help stimulate anti-inflammatory effects, which may decrease inflammation to relieve depression symptoms.
• Boosting neurotransmitters: People with depression are believed to have lower levels of certain neurotransmitters involved in mood regulation. tVNS may help stimulate feel-good neurotransmitters, including GABA and norepinephrine, which may boost and regulate your mood.

More research is needed, however, to fully understand how tVNS — and VNS — may work.

Is tVNS available?

tVNS is a developing method. Current government approval of tVNS for depression treatment reflects that.

A taVNS device called NEMOS is approved for depression and anxiety treatment in the European Union, for example. But the device has a “CE certification,” meaning it’s safe for these conditions, yet research into clinical effectiveness is ongoing.

In the United States, the FDA recently granted a “Breakthrough Device” designation to the gammaCore tcVNS device for use in PTSD treatment. This FDA designation accelerates the development and review process for medical devices that show promise as effective treatments for serious conditions.

Several clinical studies into tVNS for mental health treatment are currently underway in the United States. As research continues, government approval of tVNS devices for depression treatment may be close behind.

In the meantime, doctors may be able to prescribe tVNS devices off-label to supplement depression care. An off-label use is when a treatment is used for something other than its approved purpose. Off-label uses aren’t appropriate for everyone.

Takeaway

Transcutaneous vagus nerve stimulation, or tVNS, is an emerging treatment for depression and other mental health conditions.

Overall, tVNS is safe and early results for use as a depression treatment are promising. But more research is needed.

If more clinical studies demonstrate that this method is an effective depression treatment, tVNS could supplement existing depression care, offering a noninvasive, convenient, and home-based treatment option with few side effects.