Treatment-resistant depression is a serious problem with significant costs in terms of health care dollars and patients&rsquo; well-being. Vagus nerve stimulation (VNS) is one novel, device-based therapy that may be effective in this population. In this article, we review the evidence to date on the use of VNS in major depression and describe the process of VNS treatment initiation, device implantation, and dosage adjustment and monitoring. It is important for psychiatric nurses to understand the evidence base for and how VNS is used in treatment so they may enhance care of patients with treatment-resistant depression. <h4>ABOUT THE AUTHORS</h4> <p>Dr. Rado is Assistant Professor of Psychiatry, Department of Psychiatry, and Dr. Janicak is Professor of Psychiatry, Rush University, Chicago, Illinois.</p> <p>Dr. Rado has received research support from AstraZeneca PLC; Janssen, LP; Neuronetics, Inc.; Sanofi-aventis; and Solvay SA. Dr. Janicak has received research support from AstraZeneca PLC; Bristol-Myers Squibb; Janssen, LP; Neuronetics, Inc.; Sanofi-aventis; and Solvay SA. He is a consultant for AstraZeneca PLC; Bristol-Myers Squibb; Janssen, LP; Neuronetics, Inc.; and Pfizer, Inc. He is a speaker for Abbott; AstraZeneca PLC; Bristol-Myers Squibb; Janssen, LP; Pfizer, Inc.; and Shire plc.</p> <p>Information contained in this article is reprinted from <cite>Psychiatric Annals</cite>, Vol. 37, No. 3, pp. 197-204.</p> <p>Address correspondence to Philip G. Janicak, MD, Professor of Psychiatry, Rush University, 1720 W. Polk Street, Chicago, IL 60612; e-mail: <a href="mailto:pjanicak@rush.edu">pjanicak@rush.edu</a>.</p>