10 Life Lessons We Can Learn From Latest Depression Treatments
Latest Depression Treatments
If your depression doesn't get better through psychotherapy and antidepressants, new drugs that act quickly may be able treat treatment-resistant depression.
SSRIs are the most common and well-known antidepressants. They affect the way that the brain utilizes serotonin.
Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behaviors such as despair. The NHS offers 8 to 16 sessions.
1. Esketamine
The FDA approved the new treatment for depression in March 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is made from the anesthetic ketamine which has been proven to be effective in cases of severe of depression. The nasal spray works alongside an oral antidepressant to combat depression that has not responded to standard medications. In one study, 70% of people suffering from treatment resistant depression who received this medication responded well - a much higher response rate than just taking an oral antidepressant.
Esketamine is different from conventional antidepressants. It increases levels of naturally occurring chemicals in the brain, referred to as neurotransmitters. These chemicals transmit messages between brain cells. The results don't come immediately. Patients typically feel a little better after a few days but the effects last for a longer time than SSRIs or SNRIs. Those can take weeks to months to begin to show effects.
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 through depression and chronic stress. It also appears to stimulate the development of neurons that aid in reducing suicidal thoughts and feelings.
Another reason esketamine is different from other antidepressants is the fact that it is administered via an nasal spray which allows it to reach the bloodstream more quickly than pills or oral medication could. The drug has been found to decrease depression symptoms within a matter of hours, and in certain individuals the effects are immediately.
A recent study that followed patients for 16 weeks found that not all patients who started treatment with esketamine were actually in remission. This is disappointing, but not surprising according to Dr. Amit A. Anand an expert in ketamine who was not involved with the study.
Esketamine is currently only available in private practice or clinical trials. Esketamine is not a primary treatment for depression. It is prescribed when SSRIs and SNRIs don't be effective for a patient suffering from treatment-resistant depression. Doctors can determine if the condition is resistant to treatment and then decide whether esketamine might be beneficial.
2. TMS
TMS utilizes magnetic fields to stimulate neurons in the brain. It is non-invasive, doesn't require surgery or anesthesia and has been proven to improve depression for people who don't respond to psychotherapy or medication. It is also 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 feel like pinpricks placed on the scalp, and may take a bit of getting used to. Patients can return to their work and home immediately after a treatment. Based on the stimulation pattern employed and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.
Researchers believe that rTMS can alter the way neurons communicate. This process, referred to as neuroplasticity allows the brain form new connections and to change its function.
TMS is FDA approved to treat depression in situations where other therapies such as medication and talk therapy have not been successful. It has also been proven to be effective in treating tinnitus and OCD. Scientists are also exploring the possibility of using it to treat Parkinson's disease as well as anxiety.
While a variety of studies have found that TMS can reduce depression but not everyone who gets the treatment will experience a positive effect. Before attempting this type of treatment, it is essential to undergo a thorough medical and psychiatric evaluation. If you have a history of seizures or are taking certain medications, TMS might not be right for you.
A visit to your doctor may be beneficial if you're experiencing depression but aren't seeing any benefits from the treatment you are currently receiving. You could be eligible to participate in a TMS trial or other types of neurostimulation. But, you must first try several antidepressants before your insurance will cover the cost. If modern approaches to depression treatment I Am Psychiatry are interested in knowing more about these life-changing treatments, contact us today for a consultation. Our experts will assist you in determining if TMS treatment is suitable for you.
3. Deep brain stimulation
For people suffering from depression that is resistant to treatment, a non-invasive treatment that rewires the brain's circuits could be effective within less than a week. Researchers have devised new strategies that deliver high-dose magnetic waves to the brain quicker and with a schedule that is that is more manageable for patients.
Stanford neuromodulation therapy, now 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 pulses into specific brain regions. In a study conducted recently, Mitra and Raichle discovered that in three-quarters (75%) of patients with depression, the usual flow of neural activity from the anterior cingulate cortex and the anterior insula was disrupted. With SNT the flow of neural activity returned to normal within a week, coinciding with a reduction in their depression.
Deep brain stimulation (DBS) is an even more extensive procedure, may produce similar results in some patients. Neurosurgeons conduct a series of tests to determine the ideal place to implant one or more leads inside the brain. The leads are connected by an electrical stimulation device, which is placed beneath the collarbone. It appears like the appearance of a pacemaker. The device delivers continuous electrical current to the leads which alters the brain's natural circuitry and reduces depression symptoms.
Certain psychotherapy treatments, such as cognitive behavioral therapy and inter-personal therapy can also help alleviate depression symptoms. Psychotherapy can be conducted in a group setting or in one-on-one sessions with a mental health professional. Some therapists also offer the option of telehealth services.
Antidepressants are still the cornerstone of depression treatment. In recent times, however, there have been significant improvements in how quickly they can help alleviate 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, like electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS), use magnetic or electric stimuli to stimulate the brain. These are more complex procedures that must be done under a physician's care. In some instances, they could cause seizures and other serious side effects.
4. Light therapy
Bright light therapy, which involves sitting or working in front of a bright artificial light source, has been known for years to treat major depression disorder through seasonal patterns (SAD). Research suggests that bright light therapy can reduce symptoms such as sadness and fatigue by improving mood and regulating circadian rhythms. It also aids those who suffer from depression that is intermittent.
Light therapy works by mimicking sunlight, a key element of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is associated with mood and light therapy may rewire misaligned circadian rhythm patterns that may contribute to 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 form of depression called winter blues. It's similar to SAD but affects fewer people and only occurs in the months when there is the least amount of daylight. They suggest sitting in the light therapy box each morning for 30 minutes while awake to reap the most benefit. Light therapy can produce results within the space of a week, unlike antidepressants which can take a long time to kick in and may trigger negative side effects, such as nausea or weight gain. It is also safe for pregnant women as well as older adults.
Researchers warn against using light therapy without the supervision of an expert in mental health or psychiatrist, since it can cause manic episodes in those who suffer from bipolar disorders. It may also make some sufferers feel tired during the first week of treatment as it could alter their sleep-wake patterns.
PCPs need to be aware of any new treatments approved by the FDA. However they shouldn't dismiss the tried-and-true techniques like antidepressants or cognitive behavioral therapy. Dr. Hellerstein told Healio that while the search for newer and better treatments is exciting, we should be focusing on the most proven treatments. He says PCPs must educate their patients about the benefits of new treatments as well as assist them in sticking to their treatment plans. This may include providing transportation to the doctor's appointment, or setting up reminders to patients to take their medication and attend therapy sessions.