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Latest Depression Treatments

The good news is that if your depression does not improve with psychotherapy and antidepressants, new drugs that are fast-acting are promising for treating treatment-resistant depression.

SSRIs are the most common and well-known antidepressants. They alter the way that the brain processes serotonin, a chemical messenger.

Cognitive behavioral therapy (CBT), also known as cognitive behavior therapy, assists you in changing negative thoughts and behaviors such as hopelessness. The NHS offers 8 to 16 sessions.

1. Esketamine

In March 2019 the FDA approved a new nasal spray for depression called esketamine. (Brand name Spravato). It is derived from the anesthetic, ketamine. This has been shown to be effective in severe depression. The nasal spray is used in conjunction with an oral antidepressant for depression that isn't responding to standard medication. In one study 70 percent of those suffering from treatment-resistant extreme depression treatment given the best drug to treat anxiety and depression responded well which was a greater response rate than just an oral antidepressant.

Esketamine is different from conventional antidepressants. It increases the amount of neurotransmitters in the brain that transmit messages between brain cells. The effects aren't immediately apparent. Patients generally feel better after a couple of days, but the effects last longer than with SSRIs or SNRIs, which can take weeks or even months to take effect.

Researchers believe that esketamine helps alleviate depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections that could be found in chronic stress and depression. It also seems to promote 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 a nasal spray which allows it to enter the bloodstream more quickly than pills or oral medication can. It has been proven to decrease symptoms of depression within a matter of hours, and in some individuals the effects are instantaneous.

However the results of a study that tracked 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. Anand an expert in ketamine who was not part of the study.

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

2. TMS

TMS utilizes 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 in those who do not respond to psychotherapy or medication. It can also be used to treat obsessive-compulsive disorder (OCD) and tinnitus.

For depression, TMS therapy is typically given as a series of daily sessions spread over six weeks. The magnetic pulses can be felt as pinpricks on the scalp. It can take time to become used to. After the non pharmacological treatment for depression, patients are able to return to work or go home. Depending on the stimulation pattern used and the stimulation pattern used, each TMS session can last between 3.5 and 20 minutes.

Researchers believe that rTMS works by changing the way neurons communicate with each other. This process, also known as neuroplasticity, enables the brain to form new connections and to change its function.

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

While a variety of studies have proven that TMS can help with depression however, not everyone who receives the treatment will experience a positive effect. Before beginning this treatment, it is essential to undergo an exhaustive mental and medical evaluation. If you have any history of seizures or are taking certain medications, TMS might not be right for you.

If you have been suffering from depression but aren't seeing the benefits of your current treatment plan, having a discussion with your psychiatrist might be helpful. You could be eligible for a TMS trial or other forms of neurostimulation. However, you must first test several antidepressants before your insurance will cover the cost. Contact us today to schedule a consultation to learn more. Our experts will assist you through the process of deciding if TMS treatment is the right one for you.

3. Deep brain stimulation

For people with treatment-resistant prenatal depression treatment, a noninvasive therapy that rewires the brain's circuits could be effective within as little as a week. Researchers have devised new strategies that deliver high-dose electromagnetic waves to the brain more quickly and on a schedule more manageable for the patients.

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

Deep brain stimulation (DBS) is an invasive procedure, may produce similar effects in some patients. After several tests to determine the optimal placement, neurosurgeons implant one or more wires, known as leads, in the brain. The leads are connected by the neurostimulator. It is implanted 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, such as cognitive behavioral therapy and inter-personal therapy, can also help with depression symptoms. Psychotherapy can be done in an environment of group or one-onone sessions with a mental healthcare professional. Some therapists also offer Telehealth services.

Antidepressants are still the cornerstone of depression treatment. In recent years, however, there have been some notable improvements in how quickly they can alleviate depressive symptoms. Newer drugs to treat depression and anxiety, 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 or magnetic stimulation to stimulate the brain, like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complicated procedures that require the supervision of a physician. In certain instances, they may cause seizures as well as other serious adverse effects.

4. Light therapy

Bright light therapy involves sitting or standing in front of a bright light source. This therapy has been used for many years to treat seasonal depression as well as major depressive disorder (SAD). Studies show that bright light therapy can 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 that is intermittently present.

Light therapy works by mimicking sunlight, which is a major element of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is associated with mood, and light therapy may rewire circadian rhythm patterns which 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 kind of depression called winter blues. It's similar to SAD but affects fewer people and only occurs in the months when there is less daylight. They suggest sitting in front of a light therapy box each morning for 30 minutes while awake to reap the maximum benefit. In contrast to antidepressants that can take weeks to kick in and can cause adverse effects such as weight gain or nausea, light therapy can produce results within a week. It's also safe during pregnancy and for those who are older.

Researchers advise against using light therapy without the supervision of a mental health professional or psychiatrist, since it can trigger manic episodes in people with bipolar disorders. It may also make some people feel tired in the first week of treatment because it could alter their sleep-wake patterns.

PCPs need to be aware of the latest treatments that have been approved by the 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 newer and better treatments is exciting, we should be focusing on the most effective treatment for depression proven therapies. He suggests that PCPs should concentrate on informing their patients about the advantages of the latest treatments and help them adhere to their treatment plans. This can include providing transportation to the doctor's appointment, or establishing reminders for patients to take their medication and attend therapy sessions.