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Tucson patients who have battled severe depression for years now are turning to a pacemakerlike device to ease their prolonged and often disabling symptoms.

First tested in trials at University Medical Center, the device is implanted under the skin in the upper chest, where it fires mild electrical pulses to the brain through the vagus nerve in the neck.

Aimed at the area of the brain that controls emotion, the device regulates brain chemicals known to stabilize and elevate moods.

Only patients with long-term, severe depression who have failed to respond to at least four other therapies, including antidepressant medication and psychotherapy, are candidates for the device, known as a vagus nerve stimulator.

So far, it has been implanted in 14 patients at UMC — the first medical center to use it here since the therapy earned federal approval in July.

"This has been one of the most effective therapies I've ever tried, especially over the long term. It's awesome," said Ken Kintner, 49, who has struggled with major depression, including suicidal episodes, since he was a youngster.

"Depression can be pretty devastating. When I would fall into severe periods, it was very difficult to carry on any normal daily activities — it was like going into a deep black hole.

"Since I've had this, I still have those times when the mood goes down, but not as far and not as long. I just don't have the really deep, depressive episodes now.

"It's not a happy switch — I don't feel good all the time. But the stabilizing effect is a great help to me."

Kintner was implanted with the device four years ago, when it was still being tested at UMC. He plans to keep it, possibly for the rest of his life, he said.

Major depressive disorder is considered one of the country's most prevalent and serious illnesses, affecting nearly 19 million Americans every year. About 20 percent — or 4 million — suffer the resistant form that has plagued Kintner.

Through the years, he has tried many formulations of antidepressant medications. Some worked for a while, but all led to relapses. As a teen, he even endured electroshock therapy during an especially dangerous suicidal period — again, with only temporary effects.

"So when I first heard about this, I thought maybe this is different, something that will not wear off. I was certainly willing to give it a try," he said.

As Kintner talked, there was a very subtle change in his voice, a slight hoarseness that occurred every few minutes. That is one of the main side effects of the device, which sits close to the voice box and the esophagus.

When it fires — every five minutes for about 30 seconds — it can affect the tone of the voice slightly and also cause the sensation of difficulty swallowing and some shortness of breath.

Although about 50 percent of patients experience these side effects, only about 4 percent have had the device removed because of them, studies show.

None of the 14 patients implanted in recent months at UMC have had it removed, said Dr. Francisco Moreno, the University of Arizona psychiatrist who directed the clinical trials and manages the patients.

To date, Moreno has seen results similar to findings from the clinical trials — about half of patients with long-term major depression experience some benefit, one-third see at least a 50 percent improvement in condition, and one in six patients is depression-free after one to two years of the therapy.

The therapy is starting to be offered at about 70 U.S. medical centers and clinics in 26 states, according to the company that manufactures the device.

The effects of the therapy come on slowly, with improvement occurring after months, even a full year, of therapy, Moreno said. Patients have reported greater vitality, emotional stability and better social function in study analyses.

"I am very happy, absolutely, to have this new therapy," Moreno said. "There is such a large need for people with severe and resistant depression. We have kept running out of options for them.

"So it is definitely nice to be able to add this to our arsenal of therapies."