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Latest Depression Treatments

If your depression doesn't improve through psychotherapy and antidepressants, new drugs that act quickly may be able to treat treatment-resistant depression.

SSRIs are the most popular and well-known antidepressants. These work by changing the way the brain uses serotonin as a chemical messenger.

Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviors like hopelessness. It's available through the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved a new treatment for depression in March of 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is derived from the anesthetic, the ketamine. It has been proven to be effective in severe depression. The nasal spray is utilized in conjunction with an oral antidepressant in cases of depression that hasn't responded to standard medication to treat anxiety and depression. In one study, 70% of people with depression that was resistant to treatment received this medication did well - a greater response rate than taking an oral antidepressant.

Esketamine is different from traditional antidepressants. It increases the amount of neurotransmitters that transmit messages between brain cells. The results aren't immediate. Patients generally feel better within a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine helps alleviate depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed these connections which are weakened due to depression and stress. In addition, it seems to stimulate the development of neurons that could help to reduce suicidal ideas and feelings.

Esketamine is different from other antidepressants in that it is delivered via nasal spray. This allows it to get into your bloodstream faster than oral or pill medication. The drug has been shown to reduce depression treatment types symptoms within a matter of hours, and in some individuals the effects are immediate.

However, the results of a recent study that followed patients over 16 weeks found that not all patients who began treatment with esketamine was in Remission. This is a bit disappointing, but not surprising according to Dr. Amit A. Anand an expert in ketamine who was not part of the study.

Esketamine is available only in private practice or in clinical trials. Esketamine is not a primary option for treating depression. It is prescribed when SSRIs and SNRIs don't be effective for a patient suffering from treatment-resistant depressive disorder. A patient's doctor will determine if the disorder is resistant to treatment and determine if it is possible to use esketamine for treatment.

2. TMS

TMS makes use of magnetic fields to stimulate nerve cells in the brain. It is noninvasive and does not require surgery or anesthesia. It has been shown to aid people suffering from depression who have not been able to respond to medication or psychotherapy. It is also used to treat obsessive compulsive disorder (OCD) and tinnitus.

For depression, TMS therapy is typically given in a series of 36 daily sessions spread over six weeks. The magnetic pulses feel like a series of pinpricks on the scalp and could 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 type of stimulation employed 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, known as neuroplasticity, allows the brain to create new connections and alter its functions.

TMS is FDA approved to treat depression in situations that other treatments such as talk therapy and medication have not been successful. It has also been proven to aid those suffering from tinnitus, OCD and pain. And scientists are exploring whether it could also be used to treat Parkinson's disease.

TMS has been proven to help with depression in a number studies, however not every person who receives it will benefit. Before attempting this type of treatment, it's important to undergo an extensive mental and medical evaluation. If you have any history of seizures or are taking certain medications, TMS may not be the best option for you.

If you have been struggling with depression and are not experiencing the benefits of your current treatment plan, a chat with your psychiatrist may be beneficial. You may be a suitable candidate to try TMS or other forms of neurostimulation however, you must test various antidepressants before insurance coverage can cover the cost. Contact us today to schedule a consultation to learn more. Our experts can assist you in the process of determining whether TMS is the best choice for you.

3. Deep stimulation of the brain

A noninvasive therapy that resets the brain circuitry could be effective in as little as one week for people with depression that is resistant to treatment. Researchers have devised new methods that allow them to deliver high-dose electromagnetic 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, uses MRI imaging to direct electrodes that transmit magnetic pulses to specific areas in the brain. In a recent study, Mitra and Raichle observed that in three-quarters (75%) of patients who suffer from depression, the typical flow of neural activity from the anterior cingulate cortex and the anterior insula was disrupted. SNT restored that flow back to normal within a few days, and it was perfectly timed with the easing of extreme depression treatment.

Deep brain stimulation (DBS), a more invasive procedure, may produce similar effects in some patients. Neurosurgeons will perform a series tests to determine the most appropriate place to implant one or more leads inside the brain. The leads are connected to a nerve stimulator implanted beneath the collarbone, which appears like a heart pacemaker. The device is able to deliver an ongoing electric current through the leads. This alters the brain's natural circuitry, decreasing depression symptoms.

Certain psychotherapy treatments for depression like cognitive behavior therapy and inter-personal therapy, can also help with depression symptoms. Psychotherapy can be provided in one-on-one sessions with an expert in mental health, or in a group setting. Some psychotherapists provide online health.

Antidepressants are a key component of treatment for depression, but in recent times there have been some remarkable advancements in the speed at which these medications can work to reduce 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 treatment (ECT) or repetitive transcranial magnetic stimulation (rTMS) make use of magnetic or electric stimuli to stimulate the brain. These are more complicated procedures that need to be performed under a physician's care. In some cases, they can cause seizures or other serious side effects.

4. Light therapy

Bright light therapy, which entails sitting or working in front of a bright artificial light source, has been proven for a long time to treat major depression disorder through seasonal patterns (SAD). Studies show that bright light therapy can reduce symptoms such as sadness and fatigue by improving mood and regulating the circadian rhythms. It can also help those suffering with depression that is not a continuous one.

Light therapy mimics the sun, which is an essential element of a biological clock known as suprachiasmatic (SCN). The SCN is associated with mood, and lighttherapy can rewire circadian rhythm patterns which can trigger depression. In addition, light can lower melatonin levels, and restore the neurotransmitters' function.

Some doctors utilize light therapy to treat winter blues. This is a milder version of depression that is similar to SAD however it affects fewer individuals and is more prevalent during the months that have the least amount light. To get the most effective results, they suggest you lie in the box for 30 minutes each morning while you are awake. Light therapy results are seen in a week, unlike antidepressants which can take a few weeks to begin working and may cause negative side effects, such as nausea or weight increase. It's also safe during pregnancy and for older adults.

Researchers advise against using light therapy without the supervision of a mental health professional or psychiatrist, as it could cause manic episodes in those who suffer from bipolar disorders. It may also make some sufferers feel tired during the first week of treatment because it could alter their sleep-wake patterns.

PCPs must be aware of new treatments that have been approved by the FDA However, they shouldn't overlook tried-and-true techniques like antidepressants and cognitive behavioral therapy. Dr. Hellerstein told Healio that while the search for better and newer treatments is exciting, we should prioritize the most proven treatments. He says PCPs must educate their patients about the benefits of new treatments and aid them in sticking with their treatment plans. This could include arranging transportation to the doctor's office, or setting reminders for them to take their medications and attend therapy sessions.