VNS is a therapy for migraine, treatment-resistant depression, and OCD that you can sometimes do from home. It’s only FDA cleared for migraine treatment, though research is promising and suggests it’s likely safe for most people.
Researchers continue to discover new treatment options for people with migraine. Some help treat the pain of a migraine headache, and others help reduce the frequency of attacks.
One treatment option currently being explored is vagus nerve stimulation (VNS).
VNS isn’t considered a widely accessible therapy, but it has been Food and Drug Administration-cleared for the treatment and prevention of migraine and cluster headache.
VNS is a treatment that stimulates the vagus nerve, one of 12 pairs of cranial nerves that originate in your brain. These nerves help your brain communicate with your body in a variety of ways.
The vagus nerves — you have one on each side of your body — run from your brainstem down through your neck, chest, and abdomen.
Classic VNS therapy is FDA approved for epilepsy and treatment-resistant depression. This therapy involves an implantable, pacemaker-like device that must be placed by a neurosurgeon.
VNS for epilepsy and depression
The VNS device is implanted underneath your skin, and a wire is inserted to connect the device to your vagus nerve. The device sends mild electrical pulses through the vagus nerve into your brain. While this may sound intimidating, people don’t typically feel the pulses.
Once the device is implanted, it’s activated by swiping a magnet in front of the chest.
Noninvasive VNS devices, such as gammaCore, are FDA cleared for the treatment and prevention of migraine and cluster headache.
VNS may not work for all individuals with these conditions, but clinical trials suggest that, for many people, low-frequency and noninvasive VNS can help reduce the number of migraine days and headache intensity.
It might be helpful in cases when medication does not help alleviate symptoms.
What the research says
A 2018 systematic review indicates that noninvasive VNS devices are likely safe and well-tolerated by most people. The most common side effect is skin irritation at the application site.
A 2020 study reported mixed results from a noninvasive VNS device. While the treatment wasn’t as effective as researchers hoped, it performed well against various points of measurement.
For example, participants showed lowered pain intensity and pain relief at various points in the hours following treatment.
The study above suggests that, while VNS can be an effective and noninvasive treatment for migraine, it may not work as well as medication.
Experts believe that VNS is likely safe for most people.
It may also be helpful in lowering medication-overuse headaches. In fact, VNS may be used multiple times per day with minimal side effects.
However, those with heart issues, such as arrhythmias, and people who are pregnant may want to avoid this therapy. Not enough research on the safety in these populations has been done.
Transcranial magnetic stimulation (TMS) is another noninvasive therapy that produces electrical currents in the brain.
TMS is an in-office procedure. You wear a device on your head during each treatment session. It’s primarily used to treat mental health conditions, including depression and obsessive-compulsive disorder.
One 2021 study reported that TMS may help prevent migraine attacks in people with chronic migraine. Study participants reported:
- fewer attacks
- shorter duration of attacks
- lowered pain intensity
New developments in VNS technology have led to more convenient, noninvasive therapies. These noninvasive therapies are currently being used for migraine and cluster headache.
gammaCore is a handheld VNS device that delivers electrical pulses through your skin. People use it at home by holding it against their neck.
During a 2-minute treatment session, the device sends a series of gentle electrical pulses into your skin and toward your vagus nerve. You can use it several times daily to help treat migraine or on a regular basis to help prevent attacks.
Because the vagus nerve is one of the main highways between your brain and your body, stimulating it helps interrupt pain signals and relieve migraine pain.
It’s FDA cleared for the treatment and prevention of migraine in adults and adolescents over the age of 12. It’s also FDA cleared for the treatment and prevention of cluster headache in adults.
More VNS stimulation devices are available, too. Speak with your doctor about other available options.
FDA cleared vs. FDA approved
It’s important to understand that many medical devices are FDA cleared but not FDA approved. This is due to how devices are regulated in the United States.
FDA approval is only required for class III medical devices, which are those that pose a significant risk to someone’s health, such as a pacemaker or an insulin pump. Devices that resemble others currently on the market that have a proven safety record are typically cleared rather than approved.
One of the biggest drawbacks to VNS therapy is that it’s not usually covered by insurance.
The American Headache Society estimates that the out-of-pocket monthly cost can be as much as $700, but costs can vary widely depending on the device.
Even in cases where VNS is FDA approved, such as for treatment-resistant depression, most insurance companies still may not cover it.
If you want to try VNS for migraine treatment, a flexible spending account (FSA) or health savings account (HSA) may help pay some of the out-of-pocket costs and lower the financial burden.
It’s important to talk with a doctor about all migraine treatment options, including up-and-coming therapies and conventional treatments.
Conventional migraine treatment options may include abortive (rescue) treatments to stop a migraine attack and preventive medications, such as:
- Triptans: One of the most common migraine medications, triptans work best when you take it as soon as you start feeling mild symptoms of migraine.
- Ergotamine drugs: This older class of medications targets migraine pathways to provide pain relief.
- CGRP antagonists: These are the newest group of medications approved for the prevention of migraine attacks.
- Botox: Botox injections are an FDA approved treatment for migraine prevention.
- Pain relievers: Also called analgesics, these work to alleviate pain in multiple areas of the body — not just pain from headaches.
While not technically a migraine treatment, hormone therapies like birth control pills may help people who experience migraine attacks at specific times during their menstrual cycle.
Additionally, a doctor may recommend a combination of the following strategies:
- keeping a log of your possible migraine triggers
- stress management
- maintaining a moderate weight
- magnesium or vitamin B2 supplements, if you’re deficient in these nutrients
- CoQ10 supplements
Always ask a doctor before taking any supplements or herbs. These may interact with medications you take.
VNS is a newer potential treatment that may help stop migraine attacks and prevent them from happening. But it’s currently not FDA approved for such purposes.
The treatment can also be expensive and may not be appropriate if you have certain underlying conditions.
Just as migraine triggers may vary, treatment efficacy is highly individual. You may need to speak with your doctor about other treatments before you find what works for you.