Latest Depression Treatments

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

SSRIs are the most common and well-known antidepressants. They work by altering the way the brain uses serotonin.

Cognitive behavioral therapy (CBT) helps you to change negative thoughts and behaviors such as despair. 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 that has been proven to aid in the treatment of severe cases of depression. The nasal spray is used in conjunction alongside 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 showed good results which was a higher response rate than with only an oral antidepressant.

Esketamine is different from standard antidepressants. It boosts the levels of naturally occurring chemical in the brain, called neurotransmitters, that relay messages between brain cells. The effects aren't immediately apparent. Patients generally feel better after a few days however, the effects last much longer than SSRIs or SNRIs, which may take weeks to months to begin to show effects.

Researchers believe that esketamine helps reduce depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed these connections which are weakened due to depression and stress. It also appears to encourage the growth of neurons that can reduce suicidal feelings and thoughts.

Esketamine differs from other antidepressants in that it why is cbt used in the treatment of depression administered via nasal spray. This allows it to enter your bloodstream much faster than pill or oral medication. The drug has been proven by studies to reduce depression symptoms within a few hours. In some cases the effects can be immediate.

However, the results of a recent study that tracked patients for 16 weeks showed that not everyone who started treatment with esketamine remained in Remission. This is a bit disappointing, but not unexpected, according to Dr. Amit Anand, an expert on ketamine who was not involved in the study.

Esketamine is currently only available through a clinical trial program or in private practice. It is not considered a first-line treatment for depression and is typically prescribed when SSRIs or SNRIs have not performed for a person suffering from treatment-resistant depression. A patient's doctor can determine if the condition is resistant to treatment and discuss whether esketamine could be beneficial.

2. TMS

TMS employs magnetic fields in order to stimulate brain nerve cells. It is noninvasive and does not require surgery or anesthesia. It has been proven to help people with depression who haven't responded to medications or psychotherapy. It is also used to treat the disorder of obsessive compulsiveness and tinnitus (ringing in the ear).

TMS treatment refractory depression for depression is usually given in a series 36 daily treatments spread out over six weeks. The magnetic pulses feel similar to pinpricks placed on the scalp, and may require some time to get used to. Patients are able to return to work and home immediately after a treatment session. Based on the type of stimulation employed and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.

Researchers believe that rTMS alters the way that neurons communicate. This process, also known as neuroplasticity, enables the brain to establish new connections and alter its functions.

Presently, TMS is FDA-cleared to treat depression when other treatments such as talk therapy and medications, haven't succeeded. It has also been proven be effective in treating tinnitus as well as OCD. Scientists are currently examining whether it could also be used to treat Parkinson's disease.

While a variety of studies have found that TMS can reduce depression, not everyone who receives the treatment experiences a benefit. Before attempting this type of treatment, it is essential to undergo a thorough medical and psychiatric evaluation. TMS is not for you in the event of a history or certain medications.

If you have been struggling with depression and are not getting the benefits from your current treatment plan, a chat with your psychiatrist may be beneficial. You could be eligible to participate in the TMS trial or other types of neurostimulation. However, you must first try several antidepressants before your insurance company will cover the cost. Contact us today to set up a consultation to learn more. Our experts can assist you in the process of determining whether TMS is the best option for you.

3. Deep stimulation of the brain

A noninvasive therapy that resets the brain's circuitry may be effective in as little as one week for those suffering from treatment resistant depression. Researchers have developed new techniques that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter amount of time and at a frequency 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, uses MRI imaging to direct electrodes that transmit magnetic pulses to targeted brain regions. In a recent research, Mitra & Raichle found that in three quarters of depression patients, the normal flow of neural activity was reversed from the anterior cortex to the anterior isola. With SNT this flow was restored to normal within a week, which coincided with a lifting of their depression.

A more invasive procedure called deep brain stimulation (DBS) can yield similar results in some patients. Neurosurgeons perform a series of tests to determine the best place to implant one or more leads into the brain. The leads are connected to an electrical stimulation device, which is placed 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 helps reduce depression symptoms.

Certain psychotherapy treatments like cognitive behavioral therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be provided in one-on-one sessions with an expert in mental health, or in group settings. Some therapists offer online health.

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 treatments employ magnetic or electric stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complicated procedures that must be done under the supervision of a doctor. In certain instances, they may cause seizures and other serious adverse effects.

4. Light therapy

Bright light therapy, which involves working or sitting in front of an artificial light source, has been proven for a long time to treat major depression disorder through seasonal patterns (SAD). Research has shown that it can alleviate symptoms like fatigue and sadness by controlling circadian rhythm patterns and enhancing mood. It is also beneficial for those suffering from depression that is intermittent.

Light therapy mimics sunlight, which is a major element of the biological clock referred to as the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and lighttherapy can alter circadian rhythm patterns that can contribute to depression. Light therapy can also decrease melatonin and restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression known as winter blues. It's similar to SAD but affects fewer people and only happens in the months with the least daylight. To get the best results, they suggest that you lie in front of the light therapy box for 30 minutes every morning while awake. In contrast to antidepressants that can take weeks to work and often cause side effects such as nausea or weight gain the light therapy method can deliver results in a matter of a week. It's also safe during pregnancy and for older adults.

However, some researchers advise that a person should never try light therapy without the advice of a psychiatrist or mental health professional, as it could cause a manic episode in people with bipolar disorder. It may also make some people feel tired in the first week of treatment due to the fact that it could alter their sleep-wake patterns.

PCPs must be aware of new treatments that have been approved by the FDA However, they shouldn't overlook tried-and-true techniques such as antidepressants and cognitive behavioral therapy. "The pursuit of newer and better is exciting, but we must keep focusing on the most effective therapies," Dr. Hellerstein tells Healio. He suggests PCPs must inform their patients about the advantages of new treatments and assist them in sticking to their holistic treatment for depression plans. This can include arranging for transportation how to treat depression and anxiety without medication (check out this one from Technetbloggers) the doctor's office or setting reminders to take medications and attend therapy sessions.