DBS (deep brain stimulation) is a surgical neuromodulation method used to treat Parkinson’s disease, dystonia, and certain other movement disorders. In recent years, whether this method may also be beneficial for patients with very severe depression that does not respond to standard treatments has been investigated.
However, an important point should be stated from the outset: DBS is not currently a standard or routine treatment for depression. The method is still considered experimental and is primarily used in the context of scientific research [1,2].
What Is Treatment-Resistant Depression?
Different methods, such as antidepressant medications, psychotherapy, electroconvulsive therapy, and transcranial magnetic stimulation, may be used to treat depression.
In some patients, significant improvement cannot be achieved despite multiple treatments administered at an adequate dose and for an adequate duration. This condition may be defined as treatment-resistant depression. However, the definition may vary depending on the criteria used and the study.
Patients included in DBS studies are generally individuals who have experienced severe depression for many years and have not obtained sufficient benefit from numerous standard treatments.
What Does DBS Target in Depression?
Depression is not thought to arise from a single “malfunctioning center” in the brain. Many brain regions related to mood, motivation, reward perception, attention, and decision-making function as interconnected networks.
The purpose of DBS is not to activate a “happiness center,” but to regulate the functioning of brain networks associated with depression.
The targets being investigated include:
- -Subcallosal or subgenual cingulate region,
- -Ventral capsule–ventral striatum,
- -Nucleus accumbens,
- -Medial forebrain bundle
.
However, which target is most effective or which patient may respond better to which target has not been definitively established [1,3].
What Do Scientific Studies Show?
The results of DBS studies for depression are not entirely consistent with one another.
Marked and lasting improvements have been reported in some patients in small, open-label studies and long-term follow-up. However, because both the patient and physician know that stimulation is on in open studies, these findings alone cannot definitively demonstrate the true effect of DBS [2,4].
In a multicenter, randomized, placebo-controlled study published in 2017, subcallosal cingulate DBS did not demonstrate a significant advantage over placebo stimulation during the six-month blinded period [2].
In another randomized, double-blind study published in 2025, no significant treatment difference was found during the blinded phase between active and stimulation-off periods. In contrast, during the open-label follow-up period in which all patients received active stimulation, depressive symptoms decreased over time; response rates among evaluable patients were reported as approximately 65.7% at month 12, 69.0% at month 18, and 73.1% at month 24 [1].
These results may be interpreted in two ways:
First, it is possible that the effect of DBS emerges slowly in some patients and that blinded periods of several months are insufficient to evaluate treatment.
Second, some of the improvement observed during open-label follow-up may be related to close monitoring, expectation effects, concurrent treatments, or natural clinical fluctuations.
Therefore, although current research suggests that DBS may be beneficial for some patients, the effectiveness of this method for depression has not yet been definitively proven.
Does the Effect Occur Immediately?
The potential effect of DBS in depression is generally not as rapid as its motor effects in Parkinson’s disease.
In some patients, changes in energy, attention, or emotional response may be observed during surgery or in the first days of stimulation. However, it may take weeks or months for a lasting antidepressant effect to emerge.
Long-term follow-up has reported that improvement continues for years in some patients. However, not every patient responds, and it is not possible to reliably predict in advance who will respond [4].
Is Every Patient With Severe Depression Suitable for DBS?
No.
DBS is an invasive surgical procedure that requires electrodes to be placed in the brain. It carries risks such as infection, bleeding, seizures, device-related problems, and stimulation-related neuropsychiatric changes.
Before a patient is evaluated for DBS as part of a research study:
- -The diagnosis of depression should be confirmed in detail,
- -It should be reviewed whether previous treatments were truly administered at an adequate dose and for an adequate duration,
- -Bipolar disorder, psychotic disorders, substance use, and personality characteristics should be assessed,
- -Suicide risk should be addressed closely,
- -The patient’s adherence to the long-term follow-up and programming process should be evaluated.
This decision should be made by an experienced team in which psychiatry, functional neurosurgery, neuropsychology, and other relevant specialties work together.
Does DBS Completely Cure Depression?
Current scientific evidence does not show that DBS definitively eliminates depression or prevents it from recurring.
The goal of DBS is to reduce symptoms, improve functioning, and enhance quality of life in highly selected patients. Medication treatment, psychotherapy, or other psychiatric treatments may need to continue after DBS.
Conclusion
DBS for depression is an important and promising area of scientific research. Although long-term and marked improvements have been reported in some patients, the results of randomized and placebo-controlled studies are not yet consistent.
Therefore, it is not appropriate to present DBS as a proven treatment or a miraculous solution for depression.
For now, the most accurate description is:
DBS is a neuromodulation method being investigated for very severe, treatment-resistant depression that is becoming increasingly personalized but remains experimental.
References
- 1. Giacobbe P, Rizvi SJ, Ceniti AK, et al. Deep brain stimulation to the subgenual cingulate gyrus for treatment-resistant depression: a randomized controlled trial and 2-year long-term follow-up. Can J Psychiatry. 2026;71:266–276. doi:10.1177/07067437251369226.
- 2. Holtzheimer PE, Husain MM, Lisanby SH, et al. Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial. Lancet Psychiatry. 2017;4:839–849. doi:10.1016/S2215-0366(17)30371-1.
- 3. Wu Y, Mo J, Sui L, et al. Deep brain stimulation in treatment-resistant depression: a systematic review and meta-analysis on efficacy and safety. Front Neurosci. 2021;15:655412. doi:10.3389/fnins.2021.655412.
- 4. Crowell AL, Riva-Posse P, Holtzheimer PE, et al. Long-term outcomes of subcallosal cingulate deep brain stimulation for treatment-resistant depression. Am J Psychiatry. 2019;176:949–956. doi:10.1176/appi.ajp.2019.18121427.