Latest Depression Treatments
If your depression doesn't improve with antidepressants and psychotherapy, new drugs that act quickly may be able treat depression that is resistant to treatment.
SSRIs, or selective serotonin reuptake inhibitors are the most commonly prescribed and well-known antidepressants. They work by altering how the brain processes serotonin, an important chemical messenger.
Cognitive behavioral therapy (CBT) helps you change negative thoughts and behavior like hopelessness. The NHS offers 8 to 16 sessions.
1. Esketamine
In March 2019 the FDA approved a brand new nasal spray for depression that is called esketamine. (Brand name Spravato). It is derived the anesthetic the ketamine. It has been proven to be effective in cases of
severe depression treatment depression. The nasal spray is applied in conjunction with an oral antidepressant in cases of depression that isn't responding to standard medications. In one study, 70% of people with
treatment resistant depression who were given this
drug treatment for depression were able to respond well, which is a significantly higher response rate than just taking an oral antidepressant.
Esketamine acts differently than conventional antidepressants. It increases the amount of neurotransmitters that transmit messages between brain cells. The results aren't immediate. Patients typically feel a little better after a couple of days but the effects last longer than with SSRIs or SNRIs. Those can take anywhere from weeks to months to show results.
Researchers believe that esketamine reduces symptoms of depression by strengthening connections between brain cells. In animal studies, esketamine reversed these connections that can be broken down due to
depression treatment plan and stress. Additionally, it appears to boost the development of neurons that could help reduce suicidal thoughts and feelings.
Esketamine differs from other antidepressants because it is delivered via nasal spray. This allows it to enter your bloodstream much faster than pill or oral medication. It has been proven to decrease symptoms of depression within a matter of hours. In some individuals the effects are immediate.
However, the results of a recent study that followed patients for 16 weeks revealed that not everyone who started treatment with esketamine was in the remission phase. This is disappointing but not unexpected, according to Dr. Amit Anand, an expert on ketamine, who was not part of the study.
Esketamine is currently only available in private practice or clinical trials. Esketamine isn't a first-line option for treating depression. It is prescribed when SSRIs and SNRIs fail to help a patient suffering from treatment-resistant depression. A patient's physician can determine if their condition is not responding to
lithium treatment for depression and discuss whether it is possible to use esketamine for treatment.
2. TMS
TMS uses magnetic fields in order to stimulate brain nerve cells. It is non-invasive and does not require surgery or anesthesia. It has been proven to help patients suffering from depression who haven't responded to medications or psychotherapy. It has also been used to treat obsessive-compulsive disorder and tinnitus (ringing in the ears).
TMS therapy for depression is typically delivered in a set of 36 daily treatments spread out over six weeks. The magnetic pulses may feel like pinpricks on the scalp. It could take some time to become used to. After a treatment, patients can return to work or home. Based on the stimulation pattern used and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.
Researchers believe that rTMS can alter the way that neurons communicate. This process is referred to as neuroplasticity and lets the brain form new connections and change how it functions.
TMS is FDA approved to treat depression in situations where other therapies such as medication and talk therapy have not worked. It has also been proven to aid people suffering from tinnitus, OCD and pain. Researchers are also investigating the possibility of using it to treat Parkinson's and anxiety.
TMS has been proven to reduce depression in a number studies, however not all who receives it benefit. It is essential to have a thorough psychiatric and medical evaluation before trying this treatment. TMS is not a good option in the event of a history or certain medications.
If you have been struggling with depression but aren't seeing the benefits of your current treatment plan, a chat with your psychiatrist may be helpful. You may be a suitable candidate for a trial of TMS or other forms of neurostimulation, but you need to try several antidepressants first before insurance coverage can cover the cost. If you're looking to learn more about these life-changing treatments, contact us now for a free consultation. Our experts will guide you through the process of determining if TMS treatment is the right one for you.
3. Deep brain stimulation
A non-invasive therapy that rewires the brain circuitry could be effective in as little as one week for patients suffering from treatment resistant depression. Researchers have come up with new methods that allow them to deliver high-dose magnetic pulses to the brain in a shorter period of time and at a frequency that is more adaptable for patients.
Stanford neuromodulation therapy (SNT) SNT, which is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic utilizes MRI imaging to guide electrodes that send magnetic pulses to the targeted areas in the brain. In a study conducted recently, Mitra & Raichle found that in three quarters of patients with depression the normal neural activity was disrupted, shifting from the anterior cortex to the anterior cortex. SNT returned that flow back to normal within a couple of days, which coincided perfectly with the end of depression.
Deep brain stimulation (DBS), an even more extensive procedure, may produce similar results in some patients. Neurosurgeons perform a series of tests to determine the best place to implant one or more leads into the brain. The leads are connected by an electrical stimulation device, which is placed beneath the collarbone and looks like an electronic pacemaker. The device delivers a continuous electric current through the leads. This alters the brain’s natural circuitry, reducing depression symptoms.
Some psychotherapy treatments like cognitive behavioral therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be done in a group setting or in one-on-one sessions with an experienced mental healthcare professional. Some therapists also provide the option of telehealth services.
Antidepressants are the mainstay of depression treatment. In recent times, however, there have been significant improvements in the speed at which they can relieve symptoms of depression. Newer drugs, such as gepirone (Exxua), esketamine (Spravato), brexanolone (Zulresso) and dextromethorphan-bupropion (Auvelity), all have been shown to work faster than older antidepressants.
Other therapies, such as electroconvulsive therapy (ECT) or repeated transcranial magnet stimulation (rTMS), use electric or magnetic stimuli to stimulate the brain. These are more complex procedures that require the supervision of a doctor. In some instances they may cause seizures or other serious side effects.
4. Light therapy
Bright light therapy, which involves working or sitting in front of a bright artificial light source, has been proven for a long time to help with major depressive disorder and seasonal patterns (SAD). Studies have shown that it can ease symptoms such as sadness and fatigue by regulating circadian rhythm patterns and boosting mood. It is also a great option for those who suffer from
depression treatment guidelines that occurs and disappears.
Light therapy mimics sunlight, which is a key component of a biological clock called suprachiasmatic (SCN). The SCN is connected to mood and light therapy may rewire misaligned circadian rhythm patterns which can cause depression. Light therapy can also decrease Melatonin levels and help restore the function of neurotransmitters.
Some doctors are also using light therapy to treat a less severe type of depression referred to as winter blues, which is similar to SAD but affects fewer people and is only seen in months with the least daylight. They recommend sitting in the light therapy device each morning for 30 minutes while awake to reap the maximum benefits. Contrary to antidepressants, which may take weeks to kick in and often cause side effects like weight gain or nausea, light therapy can produce results in just one week. It is also suitable for pregnant women and older adults.
Researchers warn against using light therapy without the supervision of an expert in mental health or psychiatrist, as it could cause manic episodes in those who suffer from bipolar disorders. Some people may experience fatigue during the first week, as light therapy can reset their sleep-wake patterns.
PCPs must be aware of new treatments that have been approved by the FDA however, they shouldn't be ignoring tried-and-true approaches like antidepressants or cognitive behavioral therapy. "The pursuit of more effective and innovative treatments is exciting, but we should continue to prioritize the best-established therapies," Dr. Hellerstein tells Healio. He says PCPs should be focusing on educating their patients on the benefits of new treatments and assisting them stick to their treatment strategies. This could include offering transportation to their doctor's office or setting reminders for them to take their medication and attend therapy sessions.
