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Latest Depression Treatments

The positive side is that if your depression doesn't 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 frequently prescribed and well-known antidepressants. They affect the way the brain uses serotonin.

cognitive treatment for depression behavioral therapy (CBT) is also referred to as cognitive behavior therapy, helps you to change negative thoughts and behaviors such as despair. It's available through the NHS for 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, the ketamine. It has been proven to be effective in cases of severe depression. The nasal spray is applied in conjunction with an oral antidepressant for depression treatment brain stimulation that isn't responding to standard medications. In one study 70% of patients with treatment resistant depression who received this medication responded well - a much more rapid response rate than using an oral antidepressant.

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

Researchers believe that esketamine helps reduce depression symptoms by enhancing brain cell connections. In animal studies, esketamine reversed these connections which are weakened due meds to treat depression depression and stress. In addition, it seems to stimulate the growth of neurons that can help reduce suicidal thoughts and feelings.

Another reason esketamine is different from other antidepressants is that it is delivered via a nasal spray, which allows it to reach the bloodstream much faster than pills or oral medication could. The drug has been proven by studies to reduce depression symptoms within a few hours. In some cases the effects can be instantaneous.

However the results of a study that followed patients over 16 weeks revealed that not everyone who started treatment with esketamine remained in the remission phase. This is a bit disappointing, but not surprising according to Dr. Amit A. Anand, a ketamine expert who was not part of the study.

For now, esketamine is only available through the clinical trial program or private practices. Esketamine is not a primary option to treat depression. It is prescribed when SSRIs and SNRIs don't be effective for a patient suffering from treatment-resistant depression. A patient's physician will determine if the disorder is not responding to treatment and discuss whether it is possible to use esketamine for treatment.

2. TMS

TMS makes use of magnetic fields to stimulate nerve cells in the brain. It is non-invasive, doesn't require surgery or anesthesia and has been proven to reduce depression in people who are not responding to medication or psychotherapy. It's also been used to treat obsessive-compulsive disorder and tinnitus (ringing in the ears).

For depression, TMS therapy is typically administered as a series of 36 daily treatments over six weeks. The magnetic pulses feel similar to a series of pinpricks on the scalp and can require some time to get used to. Patients can return to their workplace and go home straight after a treatment session. Based on the type of stimulation used and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.

Scientists believe that rTMS changes the ways that neurons communicate. This process, referred to as neuroplasticity, enables the brain to form new connections and to alter its functions.

TMS is FDA approved for treating depression in cases that other treatments such as talk therapy and medication have not been successful. It has also been shown to aid those suffering from tinnitus, OCD and pain. Researchers are also investigating the possibility of using it to treat Parkinson's and anxiety.

TMS has been proven to improve depression in several studies, however not every person who receives it benefits. Before you embark on this treatment, it's important to undergo a thorough mental and medical evaluation. TMS is not suitable for you if you have a history or a history of certain medications.

A conversation with your doctor can be beneficial if struggling with depression but not seeing any benefits from your current treatment. You may be a suitable candidate to try TMS or other forms of neurostimulation, but you should try several antidepressants first before insurance coverage will cover the cost. If you're looking to learn more about these life-changing treatments, call us today for a consultation. Our specialists will guide you through the process of determining whether TMS is the best choice for you.

3. Deep stimulation of the brain

A non-invasive therapy that rewires the brain's circuitry may be effective in as little as one week for those suffering from treatment resistant depression. Researchers have come up with new techniques that deliver high-dose magnetic signals to the brain quicker and on a schedule more manageable for patients.

Stanford neuromodulation therapy (SNT), which is now offered at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic makes use of MRI imaging to guide electrodes which send magnetic pulses to targeted areas of the brain. In a recent study, Mitra & Raichle found in three quarters of patients with depression the normal flow of neural activity was reversed from the anterior cortex to the anterior cortex. With SNT the flow of neural activity returned to normal within a week, and coincided with a lifting of their depression.

Deep brain stimulation (DBS), an even more extensive procedure, can cause similar results in some patients. After an array of tests to determine the optimal place for the implant, neurosurgeons can insert one or more wires, referred to as leads, inside the brain. The leads are connected to a neurostimulator, which is implanted under the collarbone and appears like an electronic pacemaker. The device delivers an ongoing electric current through the leads. This alters the brain's natural circuitry, which reduces depression symptoms.

Certain psychotherapy treatments can help relieve depression symptoms, including cognitive behavioral therapy and interpersonal therapy. Psychotherapy can be delivered 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 depression treatment. In recent years, however, there have also been 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 therapies use electric or magnetic stimulation to stimulate the brain, like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that require the supervision of a physician. In certain instances, they may cause seizures or other serious adverse 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 many years to treat seasonal depression as well as major depressive disorder (SAD). Research suggests that bright light therapy can help reduce symptoms such as sadness and fatigue by improving mood and controlling the circadian rhythms. It is also a great option for those who suffer from depression, which comes and goes.

Light therapy works by mimicking sunlight, which is a major component of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is associated with mood, and lighttherapy can alter circadian rhythm patterns that can trigger depression. Light therapy can also decrease the production of melatonin and improve the function of neurotransmitters.

Some doctors employ light therapy to treat winter blues. This is a milder version of depression that is similar to SAD, but only is more common and is more prevalent during the seasons in which there is the least amount of sunlight. For the best results, they suggest you lie in front of the light therapy box for 30 minutes each morning while awake. Light therapy can produce results within a week, unlike antidepressants that can take a few weeks to begin working and may cause side effects such as nausea or weight gain. It is also safe for pregnant women and older adults.

However, some researchers warn that a person should never experiment with light therapy without the guidance of a psychiatrist or mental health professional, as it could cause a manic episode in those with bipolar disorder. Some people may feel tired during the first week, as light therapy can alter their sleep-wake pattern.

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 search for newer and better treatments is exciting, but we must continue to prioritize the best-established treatments," Dr. Hellerstein says to Healio. He suggests PCPs should educate their patients on the benefits of new treatments and assist them in sticking to their treatment plans. This may include providing transportation to the doctor's office or setting reminders for patients to take their medication and attend therapy sessions.