Vagus nerve stimulation (VNS) is one of a few physical methods subjected recently to investigations on their antidepressant activity. It is the only method which was officially accepted as add-on therapy for chronic and/or recurrent depressive disorder.

The paper presents a critical (from the psychiatric point of view) analysis of several selected features of VNS.

The technique of VNS has not been practically examined in experiments on animal models of depression. Sensory experiences connected with the current flow allow the patient to know if he has received true or sham stimulation. Long-term retention of patients in the placebo group (i.e. with implanted and non-operated VNS stimulator) is unethical. The majority of inves­tigations have an observational character and were made in small groups of patients. The quantity of well-planned randomized investigations is small.

Future investigations on VNS in the therapy of de­pression require some consideration and introduction of new research procedures, which will be able to restrain hitherto existing methodological disabilities.