Latest Depression Treatments
If your depression doesn't improve through psychotherapy and antidepressants new medications that respond quickly may be able treat depression resistant to treatment.
SSRIs also known as 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 to change negative thoughts and behavior, such as hopelessness. It is available on the NHS for 8 to 16 sessions.
1. Esketamine
In March 2019 the FDA approved a brand new nasal spray for depression, called esketamine. (Brand name Spravato). It is derived the anesthetic ketamine. It has been proven to be effective in severe depression. The nasal spray is applied in conjunction with an oral antidepressant to treat depression that hasn't responded to standard medications. In one study 70 percent of those suffering from treatment-resistant depression given the drug responded well -- a far higher response rate than with the use of an oral antidepressant.
Esketamine acts differently than conventional antidepressants. It increases levels of naturally occurring chemical in the brain, referred to as neurotransmitters. They transmit messages between brain cells. The results aren't immediate. Patients generally feel better after a few days but the effects last much longer than SSRIs or SNRIs, which can take weeks or even months to take effect.
Researchers believe that esketamine reduces depression symptoms through strengthening brain cell connections. In animal studies, esketamine reversed the breakdown of these connections that can be seen in depression and chronic stress. It also appears to stimulate the growth of neurons that can help reduce suicidal thoughts and feelings.
Another reason esketamine is different from other antidepressants is the fact that it is administered via nasal sprays, which allows it to reach the bloodstream faster than a pill or oral medication can. It has been proven to reduce depression symptoms within a matter of hours. In certain individuals the effects are nearly instantaneous.
A recent study that followed patients for 16-weeks found that not all patients who began treatment with esketamine were actually in the remission phase. This is not unexpected, according Dr. Amit Anand, an expert on ketamine but not involved in the study.
Esketamine is currently only available in clinical trials or in private practice. Esketamine is not a primary option for treating depression. It is prescribed when SSRIs and SNRIs fail to help a patient suffering from treatment-resistant depressive disorder. The doctor can determine whether the disorder is resistant to treatment, and then determine whether esketamine may be beneficial.
2. TMS
TMS uses magnetic fields in order to stimulate brain nerve cells. It is noninvasive and does not require surgery or anesthesia. It has been shown to help people with depression who haven't responded to medications or psychotherapy. It can also be used to treat obsessive-compulsive disorder (OCD) and tinnitus.
For depression, TMS therapy is typically delivered as a series of 36 daily sessions spread over six weeks. The magnetic pulses are similar to pinpricks that are placed on the scalp, and may be a little difficult to get used to. Patients are able to return to work and home immediately after a treatment session. Based on the stimulation pattern used and the stimulation pattern used, each TMS session can last between 3.5 and 20 minutes.
Scientists believe that rTMS changes the ways that neurons communicate. This process is referred to as neuroplasticity and lets the brain form new connections and change the way it operates.
TMS is FDA approved for treating depression in cases where other therapies such as medication and talk therapy have not been successful. It has also been proven be effective in treating tinnitus as well as OCD. Scientists are also exploring the possibility of using it to treat Parkinson's disease and anxiety.
TMS has been proven to reduce depression in several studies, however not all who receives it benefits. It is crucial to undergo a thorough psychiatric as well as medical examination prior to attempting this kind of treatment. If you have a history of seizures or are taking certain medications, TMS might not be the best option for you.
If you've been struggling with depression but aren't experiencing the benefits of your current treatment plan, a conversation with your psychiatrist could be helpful. You may be a candidate for a trial of TMS or other forms of neurostimulation but you should try various antidepressants before insurance coverage covers the cost. Contact us today to schedule a consultation to learn more. Our experts will assist you through the process of determining if TMS treatment is right for you.
3. Deep brain stimulation
For people suffering from depression that is resistant to treatment A non-invasive treatment that resets brain circuitry can be effective within just one week. Researchers have come up with new methods that allow them to deliver high-dose magnetic impulses to the brain in a shorter time and at a frequency that is more manageable for patients.
Stanford neuromodulation therapy, which is now available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences It uses MRI images to guide electrodes to send magnetic impulses to specific areas of the brain. In a study conducted recently, Mitra and Raichle discovered that in three-quarters of patients who suffer from depression, the typical flow of neural activity from the anterior cingulate cortex to the posterior insula was reversed. With SNT this flow was restored to normal within a week, which coincided with a reduction in their depression.
A more invasive technique called deep brain stimulation (DBS) may produce similar results for some patients. Neurosurgeons conduct a series of tests to determine the most appropriate placement before implanting one or more leads into the brain. depression treatment interventions are connected with an electrical stimulation device, which is inserted beneath the collarbone. It appears like the appearance of a pacemaker. The device provides an ongoing electric current through the leads. This alters the brain's natural circuitry, which reduces depression symptoms.
Certain psychotherapy treatments can help relieve depression symptoms, such as cognitive behavioral therapy and interpersonal therapy. Psychotherapy can be conducted in groups or in one-onone sessions with a mental healthcare professional. Some therapists also offer Telehealth services.
Antidepressants are still the cornerstone of depression treatment. In recent times, however there have been some notable improvements in how quickly they can alleviate depressive symptoms. 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 treatments, like electroconvulsive treatment (ECT) or repeated transcranial magnet stimulation (rTMS) make use of magnetic or electric stimuli to stimulate the brain. These are more complex procedures that need to be performed under the supervision of a physician. In some cases they can cause seizures and other serious adverse side effects.
4. Light therapy
Bright light therapy, which is sitting or working in front of a bright artificial light source, has been proven for years to treat major depressive disorder with seasonal patterns (SAD). Research has shown that it can alleviate symptoms such as sadness and fatigue by regulating the circadian rhythms and boosting mood. It also aids those suffering with depression that is not a continuous one.
Light therapy mimics sunlight, which is a key element of a biological clock referred to as suprachiasmatic (SCN). The SCN is linked to mood, and light therapy may alter circadian rhythm patterns that can trigger depression. Light therapy can also lower the production of melatonin and improve the function of neurotransmitters.
Some doctors are also using light therapy to treat a less severe form of depression referred to as winter blues. It is similar to SAD but affects fewer people and only occurs in the months when there is less daylight. They recommend sitting in the light therapy box every morning for 30 minutes while awake to get the maximum benefit. Contrary to antidepressants, which may take weeks to kick in and can often cause side effects like nausea or weight gain the light therapy method can deliver results in just a week. It is also safe for pregnant women as well as older adults.
Researchers advise against using light therapy without the supervision of a mental health professional or psychiatrist, as it could trigger manic episodes in people with bipolar disorders. Some people may feel tired within the first week due to the fact that light therapy can reset their sleep-wake cycle.
PCPs must be aware of any new treatments that have been approved by FDA. However they shouldn't dismiss tried-and-true methods like antidepressants or cognitive behavioral therapy. Dr. Hellerstein told Healio that although the quest for newer and better treatments is exciting, we should be focusing on the most well-established treatments. He says PCPs need to educate their patients about the advantages of new treatments and aid them in sticking with their treatment plans. That can include offering transportation to their doctor's appointment or setting up reminders to take medication and attend therapy sessions.