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Latest Depression Treatments

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

SSRIs are the most popular and well-known antidepressants. They alter how the brain processes serotonin as the chemical messenger.

Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviors such as despair. The NHS offers 8 to 16 sessions.

1. Esketamine

In March 2019 the FDA approved a brand new nasal spray for depression that is called esketamine. (Brand name Spravato). It is derived from the anesthetic, Ketamine. It has been proven to be effective in cases of severe depression. The nasal spray is applied in conjunction with an oral antidepressant in cases of postpartum depression treatment that isn't responding to standard medications. In one study 70% of patients with treatment resistant depression who received this medication were able to respond well, which is a significantly greater response rate than using an oral antidepressant.

Esketamine is different from traditional antidepressants. It increases the amount of neurotransmitters in the brain that transmit messages between brain cells. The results don't come immediately. Patients generally feel better after a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine improves depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed these connections that are damaged due to depression and stress. In addition, it seems to stimulate the development of neurons that aid in reducing suicidal thoughts and feelings.

Esketamine is different from other antidepressants due to the fact that it is delivered via nasal spray. This allows it to get into your bloodstream faster than pill or oral medication. The drug has been proven in studies to lessen depression symptoms within a few hours. In some instances the effects may be almost immediate.

A recent study that followed patients for 16 weeks found that not all patients who started treatment with esketamine had reached 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.

For now, esketamine is only available through the clinical trial or private practices. It is not considered a first-line treatment for Postpartum depression treatment and is typically prescribed when SSRIs or SNRIs have not worked for a person with treatment-resistant antenatal depression treatment. A doctor for a patient will determine if the disorder is not responding 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, doesn't require surgery or anesthesia and has been shown to improve depression in those who are not responding to psychotherapy or medication. It's also been used to treat obsessive-compulsive disorder and tinnitus (ringing in the ear).

TMS therapy for depression is usually delivered in a series 36 daily treatments spread out over six weeks. The magnetic treatment for depression pulses can feel like pinpricks in the scalp. It may take some time to become accustomed to. After a treatment, patients can return to work or go home. Each TMS session lasts between 3.5 minutes and 20 minutes, depending on the stimulation pattern.

Researchers believe that rTMS functions by altering the way that neurons communicate with one another. This process, referred to as neuroplasticity, enables the brain to create new connections and modify its function.

Currently, TMS is FDA-cleared to help with depression when other treatments, including talk therapy and medications, haven't succeeded. It has also been proven to be effective in treating tinnitus and OCD. Researchers are also looking into the possibility of using it to treat Parkinson's disease and anxiety.

While a variety of studies have shown that TMS can reduce depression, not everyone who receives the treatment experiences a benefit. It is essential to have a thorough psychiatric and medical evaluation prior to beginning this treatment. TMS is not a good option when you have a history of or a history of certain medications.

Talking to your doctor could be beneficial if you are suffering from depression, but are not seeing any benefits from your current treatment. You could be eligible to participate in a TMS trial or other forms neurostimulation. However, you must first try several antidepressants before your insurance will cover the cost. If you're interested in learning more about these life-changing treatments, contact us today for a consultation. Our specialists can assist you in the process of deciding whether TMS is the best choice for you.

3. Deep brain stimulation

For those suffering from treatment-resistant depression, a noninvasive therapy that rewires brain circuits can be effective in less than one week. Researchers have developed new techniques that allow them to deliver high-dose magnetic impulses to the brain in a shorter amount of time and at a frequency that is more suitable for patients.

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

Deep brain stimulation (DBS), a more invasive procedure, may produce similar results in some patients. After several tests to determine the best placement, neurosurgeons implant one or more wires, referred to as leads, into the brain. The leads are connected to a nerve stimulator implanted beneath the collarbone, which appears like a heart pacemaker. The device is able to deliver an uninterrupted electric current through the leads. This alters the brain’s natural circuitry, which reduces depression symptoms.

Some psychotherapy treatments may also help relieve depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can be offered in one-on-one sessions with an expert in mental health, or in a group setting. Therapists may also offer telehealth services.

Antidepressants are the mainstay of treatment for depression. In recent years, however, there have been some notable improvements in how quickly they can help alleviate 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 treatments employ electric or magnetic stimulation to stimulate the brain, for example electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that require under a physician's care. In some instances, they could 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 treatment has been used for a number of years to treat seasonal depression as well as major depressive disorder (SAD). Studies show that bright light therapy can help reduce symptoms such as sadness and fatigue by improving mood and controlling circadian rhythms. It is also a great option for those who suffer from depression, which is intermittently present.

Light therapy mimics sunlight, which is a crucial component of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is connected to mood, and light therapy can change the patterns of circadian rhythms that may contribute to depression. Additionally, light therapy can lower melatonin levels, and restore the neurotransmitters' function.

Some doctors utilize light therapy to treat winter blues. This is a milder form of depression that is similar to SAD however it is more common and is more prevalent during the months that have the least amount of sunlight. They suggest sitting in front of a light therapy box every morning for 30 minutes while awake to gain the maximum benefit. In contrast to antidepressants that can take weeks to begin working and can often cause side effects like weight gain or nausea the light therapy method can deliver results in just one week. It's also safe to use during pregnancy and for older adults.

However, some research experts warn that a person should never experiment with light therapy without the guidance of psychiatrists or a mental health professional, as it can trigger a manic episode in people with bipolar disorder. Some people may feel tired in the first week because light therapy can reset their sleep-wake patterns.

PCPs should be aware of new treatments that have been approved by the FDA However, they shouldn't be ignoring tried-and-true approaches like antidepressants and cognitive behavioral therapy. "The quest for newer and better treatments is exciting, but we must keep focusing on the most effective therapies," Dr. Hellerstein informs Healio. He says PCPs should focus on informing their patients on the benefits of new treatments and assisting them adhere to their treatment strategies. This could include arranging transportation to the doctor's office or setting up reminders for patients to take their medications and attend therapy sessions.