Depression Treatment Breakthroughs
With a new generation of depression treatment breakthroughs, scientists are tackling this issue with greater precision than ever before. These treatments are designed to help you avoid relapses, and discover the right medication.
Psychotherapy is an option when antidepressants aren't working. These include cognitive behavioral therapy and interpersonal psychotherapy.
Deep Brain Stimulation
Deep brain stimulation (DBS) is an operation where electrodes are placed inside the brain to target specific brain regions that are responsible for diseases and conditions like depression. The electrodes are connected to a device which emits electrical pulses to treat the condition. The DBS device is referred to as a neurostimulator. It can also be used to treat other neurological disorders, such as essential tremor, Parkinson's disease and epilepsy. The pulsing of the DBS device could "jam" circuits that cause abnormal brain activity in depression, while leaving other circuits intact.
Clinical trials of DBS for depression have demonstrated significant improvement in patients suffering from treatment-resistant depression (TRD). Despite the positive results, TRD recovery is different for every patient. Clinicians rely on the subjective reports from interviews with patients and psychiatric ratings scales that can be difficult to interpret.
Researchers from the Georgia Institute of Technology, Emory University School of Medicine, and the Icahn School of Medicine at Mount Sinai, have developed an algorithm that detects subtle changes in brain activity patterns that can differentiate them from depressive versus stable recovery states. The researchers' research was published by Nature Human Behaviour in Nature, highlights the importance of combining medical and neuroscience disciplines and computer engineering to create potentially life-changing treatments.
During the DBS procedure, doctors insert a wire-like lead inside the brain through a hole within the skull. The lead has a number of electrodes at its tip which send electrical signals to the brain. It is then connected to an extension wire that runs from the brain, up the neck and behind the ear down to the chest. The lead and extension are connected to a battery-powered stimulator under the skin of your chest.
The neurostimulator that can be programmed generates pulses of electricity to control abnormal brain activity in the regions targeted by the DBS devices. The team utilized DBS in their study to target a brain region called the subcallosal cortex (SCC). Researchers found that stimulation of the SCC resulted in an increase in dopamine levels, which could improve depression symptoms.
Brain Scanners
A doctor can employ a variety methods and tools to diagnose
depression treatments, but the brain scan is the most effective method. The technology employs imaging to track changes in brain activity at the functional and structural levels. It can be used by a patient to pinpoint the affected areas of their brain, and then determine what's happening in these areas in real-time.
Brain mapping can also help to determine which treatment is most efficient for a particular person. For example, some people are more responsive to antidepressant medication than others, but this is not always the situation. Psychologists and doctors can prescribe medications more accurately when they utilize MRI to assess the effectiveness. Knowing how their treatment is improving can increase compliance.
The difficulty of assessing mental health has hampered research despite its wide-spread prevalence. Although there is a wealth of information on depression, anxiety and other issues, a comprehensive understanding of what causes these issues has been elusive. However, the latest technology is beginning to unravel the causes behind these conditions.
For instance, a recent study published in Nature Medicine sorts depression into six distinct biological subtypes. This paves the way toward customized treatment.
Researchers used fMRI to examine the brain activity of 801 individuals with depression and 137 who did not. They looked at the connectivity and activation of brain circuits that are affected in depression, such as those that control cognition and emotions. They examined a person's brain scan at rest and while completing specific tasks.
A combination of resting-state and task-based measures was able to predict whether people would respond or not to SSRIs. This is the first time that a predictive test for psychiatry has been developed. The team is currently working on the development of an automated test that will provide these predictive results.
This could be particularly useful for people who are not responding to the standard method of treatment, like therapy and medication. About 60% of people suffering from depression don't respond to their initial
treatment refractory depression. Some of these patients could be difficult to manage with a standard treatment regimen.
Brain Implants
Sarah was suffering from a severe form of depression. She described it as a black hole that pulled her down. It was so strong that she was unable to move. She had tried all sorts of medicines however none of them had given an enduring lift. She had also undergone other treatments such as electroconvulsive therapy and ketamine injections but both did not work. Then, she decided to undergo a surgery which would allow researchers to implant electrodes in her brain and send her a specific jolt whenever she was about to experience a depressive episode.
Deep brain stimulation is a procedure that is used extensively to treat Parkinson's disease. It has also been shown to be beneficial for people who are unable to respond to treatment. But it isn't a cure; it simply aids the brain in dealing with the disease. It makes use of a device to implant small electrodes in specific areas of the brain such as the pacemaker.
In a study that was published on Monday in the journal Nature Medicine, two researchers at University of California at San Francisco (UCSF) describe how they made use of the DBS device for the first time to tailor the treatment of depression for a patient. They called it a new "revolutionary" approach that could allow customized DBS therapies to be offered to other patients.
For Sarah The team mapped the circuits in her brain and discovered that her amygdala was the source of depression episodes. They discovered that the ventral striatum, a deep part of her brain is responsible for calming her amygdala overreaction. They then placed the matchbox-sized device in Sarah's brain and attached its electrode legs shaped like spaghetti
meds to treat depression the two areas.
If a sign of depression develops the device instructs Sarah's brain to send a tiny electrical charge to the amygdala and to the ventral striatum. This jolt is meant to stop the development of depression and nudge her into a more positive mood. It's not a cure but it can make a huge impact for those who require it the most. In the future, this may be used to identify biological indicators for depression, allowing doctors the opportunity to prepare by increasing stimulation.
Personalized Medicine
Personalized medicine is a method to tailor prevention, diagnosis and treatment strategies to particular patients, based upon the information gathered through molecular profiling. medical imaging, lifestyle data, etc. This differs from traditional treatments that are designed for the typical patient. This is an all-encompassing approach that could not be efficient or efficient.
Recent studies have revealed a variety factors that contribute to
pregnancy depression treatment among different patients. These include genetic variants neurocircuitry dysfunctions, biomarkers and psychosocial markers, among others. The goal of individualized psychiatry is to incorporate these findings into clinical decision-making for optimal care. It is also meant to aid in the development and implementation of individualized treatment for psychiatric conditions like depression.
The field of individualized psychiatry continues to grow however, there are many obstacles still hindering its use in clinical settings. Many psychiatrists are not familiar with the pharmacological profile of antidepressants, which can result in a suboptimal prescription. It is also essential to consider the cost and complexity of the integration of multiomics into healthcare systems and ethical issues.
Pharmacogenetics could be a promising approach to advance the field of personalized psychiatry. It uses the genetic makeup of a patient order to determine the proper dosage of medication. This can reduce the adverse effects of drugs and increase the effectiveness of treatment, especially with SSRIs.
However, it is crucial to emphasize that this is just a potential approach and requires more research before it is widely accepted. Additionally, other factors such as environmental influences and lifestyle choices are crucial to consider. The integration of pharmacogenetics in
depression treatment must therefore be carefully balanced.
Functional neuroimaging may also be utilized to aid in the choice of antidepressants and psychotherapy. Studies have proven that pretreatment activation levels of specific neural circuits (e.g. ventral and pregenual anterior cingulate cortex) predict the response to both pharmacological and psychotherapeutic treatments. Some clinical trials have used these findings as a basis to select participants. They target those who are more active and, therefore more favorable reactions to treatment.
