Latest Depression Treatments

If your depression doesn't improve with antidepressants and psychotherapy new medications that work quickly could be able to treat treatment-resistant depression.

SSRIs are the most popular and well-known antidepressants. They affect the way that the brain utilizes serotonin.

Cognitive behavioral therapy (cbt treatment for depression), also known as cognitive treatment for depression behavior therapy, helps you to change negative thoughts and behavior such as despair. The NHS offers 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment for depression in March of 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is derived from the anesthetic ketamine which has been proven to aid in the treatment of severe cases of depression. The nasal spray is used in conjunction with an oral antidepressant for depression that hasn't responded to standard medications. In one study, 70% of people with treatment resistant depression who were given this drug 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 effects aren't immediately apparent. Patients generally feel better within a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine reduces symptoms of depression through strengthening brain cell connections. In animal studies, esketamine reversed the breakdown of these connections which can occur in depression and chronic stress. Additionally, it appears to promote the development of neurons that could help reduce suicidal thoughts and feelings.

Another reason esketamine is different from other antidepressants is that it is delivered through a nasal spray which allows it to reach the bloodstream much faster than pills or oral medication can. It has been demonstrated in studies to lessen depression symptoms within a matter of hours. In some instances the effects can be almost immediate.

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

Esketamine is available only in private treatment for depression practice or in clinical trials. Esketamine isn't a first-line option to treat depression. It is prescribed when SSRIs and SNRIs don't work for a patient with treatment-resistant depression. The doctor will determine if the disorder is resistant to treatment, and then determine whether esketamine could be beneficial.

2. TMS

TMS utilizes magnetic fields in order to stimulate brain nerve cells. It is non-invasive and does not require anesthesia or surgery. It has been proven to aid people suffering from depression who have not been able to respond to medication or psychotherapy. It has also been used to treat the disorder of obsessive compulsiveness and tinnitus (ringing in the ears).

For depression, TMS therapy is typically given as a series of 36 daily treatments spread over six weeks. The magnetic pulses feel like pinpricks 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. Depending on the stimulation pattern used the session TMS session is between 3.5 and 20 minutes.

Scientists believe rTMS works by altering the way that neurons communicate with one another. This process, known as neuroplasticity allows the brain create new connections and modify its function.

Currently, TMS is FDA-cleared to help with depression when other treatments like talk therapy or medication, haven't worked. It has also 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 help with depression in a number studies, but not everyone who receives it benefit. It is important that you undergo a thorough psychiatric and medical examination prior to attempting this kind of treatment. TMS is not for you if you have a history or are taking certain medications.

If you have been struggling with depression but aren't getting the benefits from your current treatment plan, a conversation with your psychiatrist might 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 arrange a consultation to learn more. Our experts will assist you in deciding if TMS treatment is suitable for you.

3. Deep stimulation of the brain

A non-invasive therapy that rewires the brain's circuitry could be effective in as little as one week for patients suffering from treatment resistant depression. Researchers have developed new techniques that allow them to deliver high-dose magnetic pulses to the brain in a shorter amount of time and at a frequency that is more suitable 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 recent study, Mitra & Raichle found in three quarters of patients with depression that the normal flow of neural activity was disrupted, shifting from the anterior cortex to the anterior isola. With SNT the flow of neural activity returned to normal within a week, coinciding with the lifting of their depression.

Deep brain stimulation (DBS) is a more invasive procedure, can cause similar effects in some patients. Neurosurgeons conduct a series of tests to determine the most appropriate location before implanting one or more leads into the brain. The leads are connected with an electrical stimulation device, which is inserted beneath the collarbone and looks like the appearance of a pacemaker. The device provides continuous electrical current to the leads, which alters the brain's circuitry and decreases symptoms of depression.

Some psychotherapy treatments may also aid in reducing depression symptoms, including cognitive behavioral therapy and interpersonal therapy. Psychotherapy can be done in a group setting or in one-on-one sessions with an experienced mental healthcare professional. Some therapy providers offer online health.

Antidepressants remain a cornerstone of treatment for depression. However, in recent times, there have been remarkable improvements in how quickly 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 employ electric shock treatment for depression or magnetic stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complex procedures that require the supervision of a doctor. In some instances they may cause 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 used for a long time to treat major depressive disorder with seasonal depression treatment patterns (SAD). Studies have shown that it can ease symptoms like fatigue and sadness by regulating circadian rhythm patterns and improving mood. It is also a great option for those who suffer from depression, which occurs and disappears.

Light therapy mimics sunlight which is an essential element of a biological clock known as suprachiasmatic (SCN). The SCN is linked to mood and light therapy has the ability to rewire misaligned circadian rhythm patterns which can cause depression. Additionally, light therapy can reduce melatonin levels and improve the functioning of neurotransmitters.

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 only occurs in the months when there is less daylight. To get the best results, they suggest that you sit in front of the light therapy box for 30 minutes each morning while you are awake. Light therapy can produce results within one week, unlike antidepressants, which can take a long time to kick in and can cause adverse effects like nausea or weight increase. It is also safe for pregnant women and older adults.

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

PCPs need to be aware of any new treatments that have been approved by FDA. However they shouldn't be ignoring the tried-and-true techniques like antidepressants or cognitive behavioral therapy. Dr. Hellerstein told Healio that although the quest for better and newer treatments is exciting, we should be focusing on the most well-established therapies. He says PCPs need to educate their patients about the benefits of new treatments and assist them in sticking to their treatment plans. This can include providing transportation to the doctor's appointment, or setting up reminders for patients to take their medication and attend therapy sessions.