Latest Depression Treatments

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

SSRIs, or selective serotonin reuptake inhibitors are the most commonly prescribed and well-known antidepressants. These antidepressants work by altering the way that the brain utilizes serotonin.

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

1. Esketamine

In March 2019, the FDA approved a brand new nasal spray for depression called esketamine. (Brand name Spravato). It is made from the anesthetic ketamine which has been proven to be effective in cases of severe 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% of patients suffering from what treatment is there for depression resistant depression who received this medication were able to respond well, which is a significantly higher response rate than just taking an oral antidepressant.

Esketamine is different from conventional antidepressants. It boosts the levels of naturally occurring chemical in the brain, known as neurotransmitters, that relay messages between brain cells. The effects aren't immediate. Patients usually feel better within a few days, but the effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine reduces symptoms of depression by enhancing the connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections which can be seen during depression and stress. Additionally, it appears to stimulate the development of neurons that could help to reduce suicidal ideas and feelings.

Esketamine differs from other antidepressants due to the fact that it is administered via nasal spray. This allows it to reach your bloodstream much faster than oral or pill medication. It has been proven to decrease depression treatment medicine symptoms within a matter of hours. In certain people the effects are immediately.

A recent study that followed patients for 16 weeks revealed that not all patients who began treatment with esketamine were in the remission phase. This is disappointing, but not surprising according to Dr. Amit A. Anand, a ketamine expert who was not part of the study.

Esketamine is only available in private depression treatment practice or in clinical trials. Esketamine is not a primary option to treat depression. It is prescribed when SSRIs and SNRIs do not work for a patient with treatment-resistant depression. Doctors can determine if the condition is not responding to treatment, and then determine whether esketamine could be beneficial.

2. TMS

TMS uses magnetic fields to stimulate neurons in the brain. It is noninvasive, does not require anesthesia or surgery and has been proven to reduce depression in those who are not responding to medication or psychotherapy. It can also be used to treat obsessive compulsive disorder (OCD) and tinnitus.

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

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

TMS is FDA approved for treating depression in cases that other what treatments are available for depression such as talk therapy and medication have not been successful. It has also been proven to aid people suffering from tinnitus, OCD and pain. Researchers are examining whether it can be used to treat Parkinson's disease.

While a variety of studies have shown that TMS can improve depression but not everyone who gets the treatment benefits. Before you embark on this treatment, it is important to undergo a thorough medical and psychiatric examination. TMS is not a good option in the event of a history or certain medications.

If you have been struggling with depression but aren't getting the benefits from 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 various antidepressants before insurance coverage can cover the cost. Contact us today to schedule an appointment If you're interested in knowing more. Our experts can help you through the process of deciding whether TMS is the right option for you.

3. Deep stimulation of the brain

For people suffering from depression that is resistant to treatment A non-invasive treatment that resets brain circuitry can be effective in less than one week. Researchers have come up with new methods that enable them to deliver high-dose magnetic pulses to the brain in a shorter time and at a frequency that is more adaptable for patients.

Stanford neuromodulation therapy (SNT), that is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic, uses MRI imaging to guide electrodes which send magnetic pulses to the targeted brain regions. In a recent research, Mitra & Raichle found that in three quarters (or more) of patients suffering from depression, the normal flow of neural activity was disrupted, shifting from the anterior cortex to the anterior isola. With SNT this flow was restored to normal within a week, and coincided with a lifting of their depression.

Deep brain stimulation (DBS) is an even more extensive procedure, may produce similar results in some patients. After several tests to determine the most appropriate place for the implant, neurosurgeons can insert one or more wires, known as leads, into the brain. The leads are connected to a neurostimulator that is implanted under the collarbone, which looks like a heart pacemaker. The device provides continuous electric current to the leads which alters the brain's circuitry and helps reduce depression symptoms.

Some psychotherapy treatments may also help relieve depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can be done in groups or in one-on-one sessions with an experienced mental health professional. Some therapists offer telehealth.

Antidepressants are still the cornerstone of depression treatment. In recent years, however, there have been significant advancements in the speed at which they can relieve symptoms of depression. 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 or magnetic stimulation to stimulate the brain, like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complex procedures that must be done under the supervision of a physician. In certain instances they can trigger seizures or other serious side effects.

4. Light therapy

Bright light therapy, which entails sitting or working in front of an artificial light source, has been used for years to help with major depressive disorder and seasonal patterns (SAD). Research suggests that bright light therapy can reduce symptoms such as sadness and fatigue by improving mood and controlling circadian rhythm patterns. It is also beneficial for those suffering from depression that is sporadic.

Light therapy mimics sunlight which is a major element of a biological clock referred to as suprachiasmatic (SCN). The SCN is linked to mood, and light therapy can alter the patterns of circadian rhythms that can contribute to depression. In addition, light can reduce melatonin levels and restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression treatment goals known as winter blues. It is similar to SAD but is less common and only occurs in the months with the least daylight. To achieve the most effective results, they suggest you sit in front of the light therapy box for 30 minutes each morning while you are awake. Unlike antidepressants, which can take weeks to work and can often cause side effects such as nausea or weight gain the light therapy method can deliver results in just a week. It is also suitable for pregnant women and older adults.

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

PCPs need to be aware of any new treatments approved by the FDA. However they shouldn't dismiss 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 focus on the most well-established treatments. He says PCPs must educate their patients about the benefits of new treatments and assist them in sticking to their treatment plans. That can include offering transportation to their doctor's appointment or setting reminders for them to take their medication and attend therapy sessions.