Latest Depression Treatments
The positive side is that if your depression does not improve after psychotherapy and antidepressants, new fast-acting drugs offer promise in treating depression resistant to treatment.
SSRIs are the most popular and well-known antidepressants. These antidepressants work by altering the way that the brain processes serotonin.
Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy helps you to change negative thoughts and behaviors such as despair. 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 from the anesthetic ketamine that has been proven to help in severe cases of depression. The nasal spray is utilized in conjunction with an oral antidepressant in cases of depression that hasn't responded to standard medication. In one study, 70% of people with treatment resistant depression who were given this drug were able to respond well, which is a significantly higher response rate than just using an oral antidepressant.
Esketamine acts differently than conventional antidepressants. It raises the levels of neurotransmitters that transmit messages between brain cells. The results aren't immediate. Patients generally feel better after a few days but the effects last for a longer time than with SSRIs or SNRIs, which can take weeks or even months to take effect.
Researchers believe that esketamine helps alleviate depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections that could be found in chronic stress and depression. In addition, it seems to stimulate the growth of neurons that can aid in reducing suicidal thoughts and feelings.
Another reason why esketamine is distinct from other antidepressants is that it is delivered through a nasal spray that allows it to get into the bloodstream much faster than a pill or oral medication would. The drug has been shown by studies to decrease depression symptoms within a matter of hours. In some instances the effects may be immediate.
However, the results of a study that tracked patients for 16 weeks showed that not everyone who started treatment with esketamine was in Remission. This is a bit disappointing, but not surprising, according to Dr. Amit Anand, an expert on ketamine but not involved in the study.
For now, esketamine is only available through the clinical trial program or in private practices. Esketamine isn't a first-line treatment for depression. It is prescribed when SSRIs and SNRIs do not be effective for a patient suffering from treatment-resistant depressive disorder. A doctor for a patient will determine if the disorder is not responding to treatment and discuss whether esketamine could be beneficial.
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 people with depression who haven't responded to medications or psychotherapy. It has also been used to treat obsessive-compulsive disorders and tinnitus (ringing in the ear).
For depression, TMS therapy is typically given in a series of 36 daily treatments over six weeks. The magnetic pulses feel like a series of pinpricks on the scalp and can be a little difficult to get used to. Patients are able to return to work or home after a treatment. Based on the stimulation pattern used and the stimulation pattern used, each TMS session is between 3.5 and 20 minutes.
Scientists believe that rTMS changes the way neurons communicate. This process is referred to as neuroplasticity and lets the brain form new connections and change how it operates.
TMS is FDA approved to treat depression in cases when other treatments like talk therapy and medication have not been successful. It has also been proven be effective in treating tinnitus as well as OCD. Scientists are currently examining whether it could also be used to treat anxiety and Parkinson's disease.
While a variety of studies have found that TMS can reduce depression, not everyone who receives the treatment benefits. It is crucial to undergo a thorough psychiatric as well as medical evaluation prior to beginning this kind of treatment. If you have a history of seizures or are taking certain medications, TMS might not be suitable for you.
If you have been suffering from depression but aren't seeing the benefits of your current treatment plan, a chat with your psychiatrist might be beneficial. You may be eligible for the TMS trial or other forms neurostimulation. However, you need to first try a variety of antidepressants before your insurance will cover the cost. Contact us today to schedule a consultation if you're interested in learning more about. Our specialists will guide you through the process of determining if TMS treatment is right for you.
3. Deep stimulation of the brain
For those suffering from treatment-resistant depression A non-invasive treatment that resets brain circuitry can be effective in just one week. Researchers have devised new methods that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter period of time and on a schedule that is more adaptable for patients.
Stanford neuromodulation therapy, which is currently available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences utilizes MRI images to guide electrodes to send magnetic impulses to targeted areas of the brain. In a study conducted recently, Mitra and Raichle found that in three-quarters of patients who suffer from depression, the typical flow of neural activity from the anterior cingulate cortex and the anterior insula was disrupted. SNT returned that flow back to normal within a few days, coinciding perfectly with the end of depression.
A more invasive procedure called deep brain stimulation (DBS) can produce similar results in some patients. After several tests to determine the best place for the implant, neurosurgeons can insert one or more wires, referred to as leads, inside the brain. The leads are connected with an electrical stimulation device, which is inserted beneath the collarbone. It appears like the appearance of a pacemaker. The device provides continuous electrical current to the leads which alters the brain's circuitry and helps reduce depression symptoms.
Some psychotherapy treatments may also aid in reducing depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can be done in a group setting or in one-onone sessions with a mental health professional. Some therapy providers offer telehealth.
Antidepressants are the mainstay of depression treatment. In recent years, however, there have been some notable improvements in how quickly 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 treatments, such as electroconvulsive therapy (ECT) or repeated transcranial magnet stimulation (rTMS) utilize magnetic or electric stimuli to stimulate the brain. These are more complicated procedures that require the supervision of a doctor. In some instances, they could cause seizures and other serious adverse effects.
4. Light therapy
Bright light therapy consists of sitting or standing in front of a bright light source. This therapy has been used for a number of years to treat seasonal depression and major depressive disorder (SAD). Research has shown that it can ease symptoms such as fatigue and sadness by regulating the circadian rhythms and boosting mood. It can also help people who experience depression that is intermittently present.
Light therapy works by mimicking sunlight, a key element of the biological clock called the suprachiasmatic nucleus (SCN). The SCN is associated with mood, and light therapy can rewire misaligned circadian rhythm patterns which can cause depression. Additionally, light therapy can reduce melatonin levels and restore the neurotransmitters' function.
Some doctors use light therapy to treat winter blues. This is a milder form of depression that is similar to SAD however it is more common and occurs during the seasons when there is the least amount light. To achieve the best results, they suggest you lie in front of the box for 30 minutes every morning while awake. Light therapy can produce results within the space of a week, unlike antidepressants, which can take a few weeks to begin working and may cause negative side effects, such as nausea or weight gain. 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 can trigger manic episodes in people who suffer from bipolar disorders. It can also make people feel tired during the first week of treatment due to the fact that it can alter their sleep and wake patterns.
PCPs should be aware of the new treatments that have been approved by the FDA, but they shouldn't overlook tried-and-true techniques such as antidepressants and cognitive behavioral therapy. "The search for newer and better is exciting, but we must continue to focus on the most well-established therapies," Dr. cutting-edge depression treatment tells Healio. He says PCPs should be focusing on informing their patients about the advantages of new options and helping them adhere to their treatment plans. This can include providing them with transportation to their doctor's appointment or setting up reminders to take their medication and attend therapy sessions.