Latest Depression Treatments
The good news is that, if your depression does not improve after psychotherapy and antidepressants, new drugs that are fast-acting show promise for treating depression that is resistant to treatment.
SSRIs are the most common and well-known antidepressants. They affect the way the brain uses serotonin.
Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy, assists you in changing 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 which is a nasal spray dubbed esketamine (brand name Spravato). It is derived from the anesthetic ketamine that has been proven to be effective in cases of severe of depression. The nasal spray can be used with an oral antidepressant to treat depression that hasn't responded to standard medications. In one study, 70 percent of people with depression that was resistant to treatment treated with the drug had a positive response with a much more rapid response rate than only an oral antidepressant.
Esketamine is different from conventional antidepressants. It increases the levels of neurotransmitters in the brain that transmit messages between brain cells. The results are not immediate. Patients usually feel better after a couple of days, but the effects last longer than SSRIs and SNRIs.
Researchers believe that esketamine helps reduce depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections which can occur during depression and stress. It also seems to promote the development of neurons which can help reduce suicidal thoughts and thoughts.
Esketamine is different from other antidepressants in that it is administered via nasal spray. This allows it to reach your bloodstream much faster than oral or pill medication. The drug has been shown by studies to decrease depression symptoms within a couple of hours. In some instances, the effects can be almost immediate.
However the results of a recent study that followed patients for 16 weeks revealed that not all who began treatment with esketamine was in remission. This is disappointing, but it's not surprising, according to Dr. Amit A. depression treatment guidelines www.iampsychiatry.com in ketamine who was not part of the study.
Esketamine is currently only available in clinical trials or in private practice. Esketamine isn't a first-line option for treating depression. It is prescribed when SSRIs and SNRIs fail to work for a patient with treatment-resistant depression. A patient's physician can determine if the condition is resistant to treatment and discuss whether it is possible to use esketamine for treatment.
2. TMS
TMS uses magnetic fields to stimulate nerve cells in the brain. It is non-invasive and does not require anesthesia or surgery. It has been proven to help people with depression who have not been able to respond to medication or psychotherapy. It's also been used to treat obsessive-compulsive disorders and tinnitus (ringing in the ears).
TMS therapy for depression is usually delivered in a series 36 daily treatments spread over six weeks. The magnetic pulses feel like a series of pinpricks on the scalp and can take a bit of getting used to. Patients can return to work and home immediately after a treatment. Each TMS session lasts between 3.5 minutes and 20 minutes, depending on the pattern of stimulation.
Researchers believe that rTMS can alter the way that neurons communicate. This process, known as neuroplasticity, allows the brain to form new connections and to alter its functions.
At present, TMS is FDA-cleared to help with depression when other treatments such as talk therapy and medications, haven't succeeded. It has also proven to be effective in treating tinnitus and OCD. Scientists are currently examining whether it could be used to treat anxiety and Parkinson's disease.
TMS has been proven to reduce depression in a number studies, however not all who receives it benefits. Before beginning this treatment, it is essential to undergo an exhaustive mental and medical evaluation. TMS is not a good option when you have a history of or a history of certain medications.
If you've been struggling with depression but aren't getting the benefits from your current treatment plan, a conversation with your psychiatrist may be beneficial. 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. Contact us today to set up an appointment if you're interested in learning more. Our specialists can help you through the process of deciding if TMS is the best option for you.
3. Deep stimulation of the brain
For people suffering from depression that is resistant to treatment, a noninvasive therapy that rewires brain circuits can be effective within just one week. Researchers have come up with new techniques that deliver high-dose magnetic waves to the brain more quickly and at a time 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 It uses MRI images to direct electrodes to send magnetic pulses into specific brain regions. In a recent research, Mitra & Raichle found in three quarters of patients suffering from depression, the normal flow of neural activity was reversed from the anterior cortex to the anterior isola. With SNT, that flow returned to normal within a week, which coincided with the lifting of their depression.
A more invasive technique called deep brain stimulation (DBS) can yield similar results in some patients. After an array of tests to determine the best location, neurosurgeons insert one or more wires, known as leads, inside the brain. The leads are connected to an electrical stimulation device, which is inserted beneath the collarbone and looks like an electronic pacemaker. The device provides an uninterrupted electric current through the leads. This alters the brain’s natural circuitry, decreasing depression symptoms.
Some 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 telehealth services.
Antidepressants are the mainstay of depression treatment. In recent times, however, there have been significant improvements in how quickly 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 treatments, such as electroconvulsive treatment (ECT) or repetitive transcranial magnet stimulation (rTMS), use electric or magnetic stimuli to stimulate the brain. These are more complicated procedures that must be done under the supervision of a physician. In certain instances they may cause seizures or other serious side effects.
4. Light therapy
Bright light therapy involves sitting or standing in front of an artificially bright light source. This therapy has been used for many years to treat seasonal depression and major depressive disorder (SAD). Research suggests that bright light therapy can help reduce symptoms like fatigue and sadness by boosting mood and regulating circadian rhythm patterns. It is also a great option for those who suffer from depression, which is intermittently present.
Light therapy works by mimicking sunlight, which is a crucial component of the biological clock called the suprachiasmatic nucleus (SCN). The SCN is associated with mood and light therapy may change the patterns of circadian rhythms that can contribute to depression. Light therapy can also decrease the production of melatonin and improve the function of neurotransmitters.
Some doctors are also using light therapy to treat a less severe form of depression known as winter blues. It's similar to SAD but affects fewer people and only occurs in the months with the least daylight. They suggest sitting in the light therapy box every morning for 30 minutes while awake to get the maximum benefit. Light therapy produces results in the space of a week, unlike antidepressants which can take weeks to kick in and may cause adverse effects like nausea or weight gain. It's also safe to use during pregnancy and in older adults.
Researchers advise against using light therapy under the supervision of an expert in mental health or psychiatrist, because it can cause manic episodes in those with bipolar disorders. It may also make some people feel tired during the first week of treatment due to the fact that it could alter their sleep-wake patterns.
PCPs must be aware of the latest treatments approved by the FDA. However, they shouldn't ignore traditional methods such as antidepressants and 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 well-established treatments. He suggests that PCPs should concentrate on educating their patients about the advantages of new options and helping them stick to their treatment strategies. This could include arranging for transportation to the doctor's office or setting reminders to take medications and attend therapy sessions.