Vagus nerve stimulation (VNS)

If you want to know about vagus nerve stimulation surgery or wearable devices, we have information to help you find out more.

What is vagus nerve stimulation?

The vagus nerve is a long nerve that connects different body parts, including the heart, brain and gut. Some of us find that we can improve symptoms of anxiety and stress by calming this nerve using electronic devices.

Vagus nerve stimulation (VNS) treatment can be:

• A type of surgery where doctors implant a device that connects to the vagus nerve internally
• A non-surgical treatment which involves wearing a device that we can take on and off

While VNS surgery is rare in the UK, doctors might use it to treat some mental health problems. Such as severe depression. Doctors might also use VNS surgery to treat neurological conditions. Such as epilepsy.

Some research suggests that VNS surgery can reduce the intensity of symptoms of severe depression. Especially when other treatments haven't helped. We might hear this called ‘treatment-resistant depression’.

The National Institute for Health and Care Excellence (NICE) produces guidelines on best practice in healthcare. NICE recommends using VNS surgery for treatment-resistant depression. But says doctors should only offer it under certain conditions. These include:

• Your doctor should talk to you about the procedure, risks and side effects. This means you can then give informed consent. To find out more, see our information on consent to treatment.
• After having the procedure, you should have regular check-ups with your doctor to see if the treatment is working. Or to check if it's causing any problems.

If you'd like to read more about this research and guidance, visit the NICE website.

How does VNS surgery work?

If you choose to have VNS surgery, doctors will perform a procedure to implant a device.

Generally, the procedure for VNS is as follows:

• Doctors put you under anaesthetic. They might use general anaesthetic, which makes you go to sleep. Or local anaesthetic, where you stay awake but have certain parts of your body numbed.
• Doctors implant a small electrical device under the skin. Just below your collar bone on your chest. The VNS device is similar to a pacemaker.
• Doctors attach this device to the vagus nerve, which is in the left side of your neck. The nerve naturally sends signals to your brain. They attach the device to the nerve using wires.
• When the connection is complete, the VNS device sends electrical pulses to your vagus nerve to stimulate the natural process. The VNS device automatically sends electrical pulses for 30 seconds, every 5 minutes.
• The VNS device stays implanted until it runs out of battery. This can take between 3 and 8 years. Doctors can also turn off or remove your VNS device, if you need them to.

After having the VNS device implanted, your mood might improve. And the intensity of some symptoms of depression might reduce. But research suggests you might not notice any improvements for several months. Or longer.

VNS surgery doesn't work for everyone. You might also need to continue other treatments alongside VNS. And there's limited evidence on how this treatment might improve symptoms of depression.

What are the side effects of VNS surgery?

The possible side effects of VNS surgery might include:

• Feeling hoarse
• Changes to your voice
• Coughing
• Headaches
• Neck pain
• Feeling prickles or tingles in your skin
• Sore throat
• Difficulty breathing
• Difficulty swallowing
• Risk of infection or other complications from surgery

For side effects caused by the device itself, your doctor might be able to reduce the intensity or frequency of the electrical pulses. This might help to improve certain side effects. Or they might also improve over time.

Your doctor should tell you about risks and side effects before you give consent to having VNS surgery.

How can I get VNS surgery?

In the UK, doctors rarely offer VNS surgery for mental health problems. This treatment can be difficult to access. It's only available in specialist centres, in certain areas of the UK. You'll also need a psychiatrist to refer you to get VNS surgery.

It's unlikely that doctors will offer this unless you've tried at least 2 other types of treatments, and they haven't worked. These might include treatments like talking therapy or medication.

To find out more about how to access VNS, try speaking with your doctor or mental health team.

What should I ask before getting VNS surgery?

If your doctor recommends that you have surgery for VNS, you should try asking some questions to learn more. Or you could ask someone you trust, or an advocate, to ask these questions for you:

• Why have you suggested that I try a VNS implant?
• What are the benefits of getting this surgery for me?
• How likely is it that VNS will work for me?
• What are the risks and side effects of surgery for VNS?
• What does the procedure to implant a VNS device involve?
• What other treatment options are available to me?
• Have you already offered me every other available treatment?
• What happens if VNS doesn't work?
• What happens if something goes wrong?
• How long will it take me to recover from surgery?
• How long until I might feel the benefits of VNS?

What are wearable VNS devices?

You can get wearable VNS devices instead of having a device implanted. This type of VNS treatment doesn't involve surgery.

Usually, you choose the device based on where you'd prefer to wear it. There are several places where you can wear a device on your body, such as:

• Clipped on your ear
• Around your neck
• Placed on your chest

A small electrical current goes through the device. In some studies, users suggested the device helped improve depression, stress and anxiety.

But there's not enough research on how well wearable devices can treat these mental health problems.

The NHS does not currently offer wearable VNS devices as a treatment for depression, stress or anxiety. Some private healthcare providers might offer this, but the devices are expensive. For many of us, the cost of VNS through private care might feel unaffordable.

What if VNS doesn't work?

It might feel frustrating or disappointing if a VNS implant or wearable device doesn't work for you. Especially if you've already tried lots of different things to treat depression, stress or anxiety. 

If you had surgery for VNS, but you and your doctor decide the treatment isn't helping, they can remove the device. Or they can leave it in, but switch it off. It depends on your preference.

If VNS doesn't work for you, try to not to blame yourself. And remember that different things work for different people. You could talk to your doctor about other options you could try.

Last reviewed: May 2026

Next review planned: May 2029