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Latest Depression Treatments

The good news is that if your depression doesn't improve after treatment with psychotherapy or antidepressants, new drugs that are fast-acting show promise for treating depression that is resistant to treatment.

SSRIs are the most popular and well-known antidepressants. They work by altering the way that the brain processes serotonin which is an important chemical messenger.

Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviors, such as hopelessness. The NHS offers 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment for depression in March of 2019, a nasal spray called esketamine (brand name Spravato). It is derived from the anesthetic ketamine, which has been shown to help in severe cases of depression. The nasal spray can be used alongside an oral antidepressant to treat depression that has not responded to standard medication. In one study 70% of patients with treatment resistant depression (Morphomics.science) who received this medication were able to respond well, which is a significantly greater response rate than taking an oral antidepressant.

Esketamine differs from standard antidepressants. It increases the amount of neurotransmitters that transmit messages between brain cells. The effects aren't immediate. Patients typically feel a little better after a couple of days, but the effects last longer than SSRIs or SNRIs, which may take weeks or even months to show results.

Researchers believe that esketamine reduces symptoms of depression by strengthening brain cell connections. In animal studies, esketamine reversed these connections which are weakened through depression and chronic depression treatment stress. It also appears to stimulate the development of neurons which can decrease suicidal feelings and thoughts.

Another reason esketamine is different from other antidepressants is that it is delivered through an nasal spray, which allows it to get into the bloodstream faster than pills or oral medication could. It has been demonstrated in studies to lessen depression symptoms within a few hours. In some instances the effects can be instantaneous.

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

Esketamine is currently only available through a clinical trial or private practice. It is not considered a first-line treatment option for depression, and is typically prescribed when SSRIs or SNRIs haven't worked for a person with treatment-resistant depression. Doctors can determine if the disorder is resistant to treatment and then discuss whether esketamine might 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 shown to aid people suffering from 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 administered in a series of 36 daily treatments for depression spread over six weeks. The magnetic pulses are similar to pinpricks that are placed on the scalp and could take a bit of getting used to. After a treatment, patients can return to work or home. Each TMS session can last between 3.5 minutes and 20 minutes, based on the pattern of stimulation.

Researchers believe that rTMS alters the ways that neurons communicate. This process is referred to as neuroplasticity and allows the brain to form new connections and change how it operates.

Presently, TMS is FDA-cleared to treat depression when other treatments such as talk therapy and medication, have not worked. It has also proven to be effective in treating tinnitus and OCD. Scientists are also exploring the possibility of using it to treat Parkinson's and anxiety.

While a variety of studies have proven that TMS can improve depression however, not everyone who receives the treatment for manic depression will experience a positive effect. It is crucial to undergo a thorough psychiatric as well as medical evaluation before trying this kind of treatment. TMS is not suitable for you in the event of a history or are taking certain medications.

If you have been struggling with depression but aren't seeing the benefits of your current treatment plan, having a discussion with your psychiatrist might be helpful. You may be a candidate to try TMS or other forms of neurostimulation but you need to try several antidepressants first before insurance coverage will cover the cost. If you're looking to learn more about these life-changing treatments, call us today to schedule a consultation. Our experts will assist you in deciding if TMS treatment is right for you.

3. Deep brain stimulation

A noninvasive therapy that resets the brain's circuitry could be efficient in just one week for patients suffering from treatment resistant depression. Researchers have come up with new methods that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter amount of time and on a schedule that is more adaptable for patients.

Stanford neuromodulation therapy (SNT) SNT, which is now offered at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic utilizes MRI imaging to direct electrodes that transmit magnetic pulses to specific areas of the brain. In a recent research, Mitra & Raichle found that in three quarters (or more) of patients suffering from depression, the normal neural activity was reversed from the anterior cortex to the anterior cortex. SNT restored that flow back to normal within a couple of days, and it was perfectly timed with the end of their depression.

Deep brain stimulation (DBS), an even more extensive procedure, can produce similar effects in some patients. After an array of tests to determine the best placement, neurosurgeons implant one or more wires, known as leads, into the brain. The leads are connected by a neurostimulator, which is placed under the collarbone and appears like a pacemaker. The device is able to deliver a continuous electric current through the leads. This alters the brain's natural circuitry, decreasing depression symptoms.

Certain psychotherapy treatments can aid in reducing depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can take place in an environment of group or one-on-one sessions with a mental healthcare professional. Some therapists also offer Telehealth services.

Antidepressants remain a cornerstone of treatment for depression, and in recent times, there have been remarkable advancements in the speed at which these drugs can alleviate depression 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, such as electroconvulsive treatment depression (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 the supervision of a doctor. In some instances, they could cause seizures and other serious side effects.

4. Light therapy

Bright light therapy, which involves 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). Studies show that bright light therapy can help reduce symptoms like fatigue and sadness by improving mood and regulating circadian rhythm patterns. It is also beneficial for those suffering with depression that is not a continuous one.

Light therapy mimics sunlight which is an essential component of a biological clock referred to as suprachiasmatic (SCN). The SCN is connected to mood and light therapy may alter the circadian rhythms that may contribute to depression. Light can also reduce Melatonin levels and help restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression called winter blues, which is similar to SAD but affects fewer people and only happens in the months when there is less daylight. To achieve the best results, they recommend that you lie in front of the light therapy box for 30 minutes each morning while you are awake. Unlike antidepressants, which can take weeks to begin working and can often cause side effects such as nausea or weight gain light therapy can provide results within one week. It's also safe to use during pregnancy and for older adults.

However, some research experts warn that a person should never experiment with light therapy without consulting of psychiatrists or a mental health professional because it could cause a manic episode in bipolar disorder sufferers. It may also make some people feel tired during the first week of treatment because it can reset their sleep-wake patterns.

PCPs should be aware of the 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 although the quest for newer and better treatments is exciting, we should prioritize the most established therapies. He says PCPs need to educate their patients on the benefits of new treatments as well as aid them in sticking with their treatment plans. This could include arranging transportation to the doctor's office or establishing reminders for them to take their medications and attend therapy sessions.