Latest Depression Treatments

The good news is that if your depression does not improve after psychotherapy and antidepressants, the latest fast-acting medications offer promise in treating depression that is resistant to treatment.

SSRIs are the most common and well-known antidepressants. They alter the way that the brain processes serotonin which is an important chemical messenger.

Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviours such as despair. It is available on the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment lithium for treatment resistant depression depression in March of 2019 nasal spray known as esketamine (brand name Spravato). It is derived from the anesthetic Ketamine. This has been shown to be effective in severe depression. The nasal spray works alongside an oral antidepressant to treat depression that hasn't responded to standard medication. In one study 70% of patients with depression that was resistant to treatment were given this drug responded well - a much higher response rate than just taking an oral antidepressant.

Esketamine acts differently than conventional antidepressants. It raises the levels of neurotransmitters that transmit messages between brain cells. The effects aren't immediate. Patients usually feel better after a few days however, the effects last for a longer time than with SSRIs or SNRIs, which can take weeks to months to take effect.

Researchers believe that esketamine reduces symptoms of depression by enhancing connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections that can occur in chronic stress and Hormonal depression Treatment. It also appears to encourage the growth of neurons that can decrease suicidal feelings and thoughts.

Esketamine differs from other antidepressants in that it is administered via nasal spray. This allows it to reach your bloodstream faster than pill or oral medication. It has been proven to decrease symptoms of depression within a matter of hours, and in certain people, the effects are almost instantaneous.

A recent study that tracked patients for 16 weeks found that not all patients who started treatment with esketamine were in remission. This is a bit disappointing, but not unexpected, according Dr. Amit Anand, an expert on ketamine for treatment resistant depression 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 option for depression and is typically prescribed when SSRIs or SNRIs have not been effective for a patient suffering from treatment-resistant depression. The doctor will determine if the disorder is resistant to treatment depression, and then determine whether esketamine could be beneficial.

2. TMS

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

For depression, TMS therapy is typically delivered in a series of 36 daily treatments over six weeks. The magnetic pulses may feel like pinpricks in the scalp. It could take some time to become accustomed to. Patients are able to return to work or home following a treatment. Based on the stimulation pattern employed and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.

Researchers believe that rTMS works by altering the way that neurons communicate with each other. This process, referred to as neuroplasticity allows the brain form new connections and to modify its function.

Currently, TMS is FDA-cleared to treat agitated depression treatment when other treatments, including talk therapy and medication, have not worked. It has also been proven be effective in treating tinnitus as well as OCD. Researchers are also investigating the possibility of using it to treat Parkinson's disease and anxiety.

TMS has been proven to help with depression in a number studies, but not everyone who receives it benefits. Before beginning this treatment, it is important to undergo an extensive medical and psychiatric evaluation. If you have any history of seizures or are taking certain medications, TMS might not be right for you.

If you have been struggling with depression but aren't seeing the benefits of your current treatment plan, having a discussion with your psychiatrist may be helpful. You could be eligible for the TMS trial or other forms neurostimulation. However, you need to first test several antidepressants before your insurance will cover the cost. If you are interested in knowing more about these life-changing treatments, contact us today to schedule a consultation. Our experts will guide you through the process of the decision of whether TMS treatment is suitable for you.

3. Deep stimulation of the brain

For people with treatment-resistant depression A non-invasive treatment that rewires brain circuits can be effective in just one week. Researchers have developed new methods that deliver high-dose magnetic waves to the brain quicker and at a time that is that is more manageable for patients.

Stanford neuromodulation therapy, which is now available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences utilizes MRI images to guide electrodes to send magnetic impulses to specific brain regions. In a recent study Mitra and Raichle discovered that in three-quarters (75%) of patients suffering from depression, the normal flow of neural activity from the anterior cingulate cortex to the posterior insula was reversed. SNT returned that flow to normal within a couple of days, coinciding perfectly with the lifting of their depression.

A more in-depth procedure known as deep brain stimulation (DBS) can yield similar results in some patients. After a series of tests to determine the optimal placement, neurosurgeons implant one or more wires, called leads, in the brain. The leads are connected to a nerve stimulator implanted beneath the collarbone, which looks like a heart pacemaker. The device provides a continuous electric current through the leads. This alters the brain’s natural circuitry, decreasing depression symptoms.

Some psychotherapy treatments may also help alleviate depression symptoms, including cognitive behavioral therapy and interpersonal therapy. Psychotherapy can take place in an environment of group or one-on-one sessions with a mental health professional. Some therapists also offer Telehealth services.

Antidepressants are still the cornerstone of depression treatment. In recent times, 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 magnetic or electric stimulation to stimulate the brain, like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that require under a physician's care. In certain instances, they can cause seizures or other serious adverse side effects.

4. Light therapy

Bright light therapy, which involves working or sitting in front of an artificial light source, has been used for many years to treat major depression disorder through seasonal patterns (SAD). Studies show that bright light therapy can reduce symptoms such as sadness and fatigue by boosting mood and regulating the circadian rhythms. It can also help those who suffer from depression that is intermittent.

Light therapy mimics sunlight, a key component of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and light therapy can rewire circadian rhythm patterns which can trigger depression. In addition, light therapy can reduce melatonin levels and restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe form of depression known as winter blues. It is similar to SAD but is less common and only happens in the months when there is less daylight. For the most effective results, they recommend that you sit in front of the box for 30 minutes every morning while awake. Light therapy produces results in one week, unlike antidepressants which can take weeks to kick in and may cause negative side effects, such as nausea or weight increase. It is also safe for pregnant women and older adults.

Researchers advise against using light therapy under the supervision of an expert in mental health or psychiatrist, as it can trigger manic episodes for people with bipolar disorders. Some people may experience fatigue in the first week because light therapy can reset 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 quest for newer and better is exciting, but we should continue to focus on the most well-established 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 treatment plans. This can include providing transportation to the doctor's appointment, or establishing reminders for them to take their medications and attend therapy sessions.