Latest Depression Treatments

The good news is that, if your depression does not improve after psychotherapy and antidepressants, new fast-acting drugs are promising for treating treatment-resistant depression treatment no medication.

SSRIs, or selective serotonin-reuptake inhibitors, are the most commonly prescribed and well-known antidepressants. These work by changing how the brain processes serotonin which is the chemical messenger.

Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behavior such as despair. The NHS offers 8 to 16 sessions.

1. Esketamine

The FDA approved a new treatment for depression in March 2019, a nasal spray called esketamine (brand name Spravato). It is derived from the anesthetic Ketamine. It has been proven to be effective in severe depression. The nasal spray is applied in conjunction with an oral antidepressant in cases of depression that hasn't responded to standard medications. In one study, 70% of people suffering from treatment resistant depression who were given this drug were able to respond well, which is a significantly more rapid response rate than taking an oral antidepressant.

Esketamine is different from standard antidepressants. It raises the levels of neurotransmitters in the brain that 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 anywhere from weeks to months to begin to show effects.

Researchers believe that esketamine reduces symptoms of depression by strengthening the connections between brain cells. In animal studies, esketamine reversed these connections which are weakened by chronic stress and depression. In addition, it seems to promote the development of neurons that help to reduce suicidal ideas and feelings.

Another reason why esketamine is distinct from other antidepressants is that it is administered via a nasal spray, which allows it to enter the bloodstream faster than a pill or oral medication would. It has been demonstrated by studies to reduce menopause depression treatment symptoms within a matter of hours. In certain instances the effects may be instantaneous.

A recent study that tracked patients for 16-weeks found that not all patients who started treatment resistant depression treatment with esketamine were in the remission phase. This is disappointing, but not surprising according to Dr. Amit A. Anand an expert in ketamine who was not involved with the study.

At present, esketamine is only available through a clinical trial or private practice. It isn't considered a first-line treatment for depression and is typically prescribed only when SSRIs or SNRIs haven't worked for a person with treatment-resistant depression. Doctors can determine if the condition is resistant to treatment and then decide whether esketamine could be beneficial.

2. TMS

TMS uses magnetic fields in order to stimulate brain nerve cells. It is noninvasive, doesn't require anesthesia or surgery and has been shown to improve depression for people who don't respond to psychotherapy or medication. It is also used to treat obsessive-compulsive disorder and tinnitus (ringing in the ear).

For depression, TMS therapy is typically given in a series of 36 daily treatments spread over six weeks. The magnetic pulses are similar to pinpricks that are placed on the scalp and could be a little difficult to get used to. Patients are able to return to work or home after a treatment session. Each TMS session lasts between 3.5 minutes and 20 minutes, based on the pattern of stimulation.

Scientists believe rTMS works by changing the way neurons communicate with one another. This process, referred to as neuroplasticity, enables the brain to establish new connections and modify its function.

TMS is FDA approved to treat depression in cases when other treatments like medications and talk therapy have not worked. It has also been proven to be effective in treating tinnitus as well as OCD. Researchers are also looking into the possibility of using it to treat Parkinson's disease as well as anxiety.

TMS has been proven to reduce depression in several studies, however not every person who receives it benefits. It is crucial to have a thorough psychiatric and medical evaluation prior to beginning this natural treatment for depression. If you have any history of seizures or are taking certain medications, TMS may not be right for you.

If you have been suffering from depression and aren't experiencing the benefits of your current treatment plan, a chat with your psychiatrist might be helpful. You may be a suitable candidate to try TMS or other forms of neurostimulation, but you should try several antidepressants before insurance coverage covers the cost. Contact us today to schedule a consultation to learn more about. Our specialists can assist you in the process of determining whether TMS is the best choice for you.

3. Deep stimulation of the brain

For people suffering from depression that is resistant to treatment, a non-invasive treatment that rewires brain circuits can be effective within just one week. Researchers have developed new methods that deliver high-dose magnetic signals to the brain faster and with a schedule that is that is more manageable for patients.

Stanford neuromodulation therapy (SNT), which is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic utilizes MRI imaging to guide electrodes which send magnetic pulses to specific areas of the brain. In a recent study, Mitra & Raichle found that in three quarters of patients suffering from depression that the normal neural activity was reversed from the anterior cortex to the anterior cortex. With SNT this flow was restored to normal within a week, coinciding with a reduction in their depression.

Deep brain stimulation (DBS), a more invasive procedure, can produce similar effects in some patients. Neurosurgeons conduct a series of tests to determine the most appropriate place to implant one or more leads into the brain. The leads are connected to a neurostimulator that is implanted beneath the collarbone, which appears to be a heart-pacemaker. The device provides continuous electrical current to the leads which alters the brain's circuitry and decreases symptoms of depression.

Certain psychotherapy therapies, 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. Therapists may also offer Telehealth services.

Antidepressants are the mainstay of treatment for depression. In recent times, however, there have also been notable improvements in the speed at which 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 therapies employ magnetic or electric stimulation to stimulate the brain, for example electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complicated procedures that require a doctor's supervision. In certain instances they can trigger seizures or other serious adverse side effects.

4. Light therapy

Bright light therapy, which is working or sitting in front of a bright artificial light source, has been known for many years to treat major depressive disorder with seasonal patterns (SAD). Research has shown that it can alleviate symptoms such as fatigue and sadness by controlling circadian rhythm patterns and boosting mood. It also aids people who suffer from depression, which is intermittently present.

Light therapy mimics sunlight which is a major component of a biological clock known as suprachiasmatic (SCN). The SCN is linked to mood, and light therapy can alter the circadian rhythms which can cause depression. In addition, light can lower melatonin levels, and restore the neurotransmitters' function.

Some doctors are also using light therapy to treat a less severe type of depression called winter blues. It is similar to SAD but affects fewer people and is only seen in months when there is the least amount of daylight. To achieve the most effective results, they suggest that you sit in the light therapy box for 30 minutes each morning while you are awake. Light therapy results are seen in the space of a week, unlike antidepressants which can take weeks to kick in and can cause negative side effects, such as nausea or weight increase. It's also safe to use during pregnancy and in older adults.

However, some research experts warn that one should never try light therapy without consulting of psychiatrists or a mental health professional, because it can trigger a manic episode in bipolar disorder sufferers. Some people may feel tired during the first week, as light therapy can reset their sleep-wake cycle.

PCPs need to be aware of new treatments approved by the FDA. However, they shouldn't ignore the tried-and-true techniques like antidepressants or cognitive behavioral therapy. "The pursuit of newer and better is exciting, but we must continue to prioritize the best-established treatments," Dr. Hellerstein tells Healio. He suggests PCPs should inform their patients about the benefits of new treatments and help them stick with their treatment plans. This can include providing them with transportation to their doctor's office or setting reminders to take their medication and attend therapy sessions.