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Latest Depression Treatments

If your depression doesn't improve by taking antidepressants or psychotherapy new medications that respond quickly may be able to treat depression resistant to treatment.

SSRIs are the most popular and well-known antidepressants. They affect the way the brain uses serotonin.

Cognitive behavioral therapy (CBT) is also referred to as cognitive behavior therapy, assists you in changing negative thoughts and behavior 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 called esketamine. (Brand name Spravato). It is derived the anesthetic, ketamine. It has been proven to be effective in cases of severe depression. The nasal spray is used in conjunction with an oral antidepressant to treat depression that hasn't responded to standard medications. In one study, 70% of people with treatment 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 standard antidepressants. It increases the levels of neurotransmitters in the brain that transmit messages between brain cells. The results aren't immediate. Patients typically feel better after a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine helps alleviate depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections that can be found in chronic stress and depression. Additionally, it appears to promote the growth of neurons that can aid in reducing suicidal thoughts and feelings.

Another reason why esketamine is distinct from other antidepressants is that it is delivered through a nasal spray, which allows it to reach the bloodstream much faster than pills or oral medication would. It has been demonstrated by studies to decrease post natal depression treatment symptoms within a matter of hours. In some instances the effects may be immediate.

However, the results of a study that tracked patients for 16 weeks showed that not all who began treatment with esketamine remained in remission. This is a bit disappointing, but not unexpected, according to Dr. Amit Anand, an expert on ketamine but not part of the study.

Esketamine is currently only available in private practice or clinical trials. Esketamine is not a primary option for treating mild depression treatments. It is prescribed when SSRIs and SNRIs do not be effective for a patient suffering from treatment-resistant depressive disorder. A doctor for a patient can determine if their condition is refractory to treatment and discuss whether the use of esketamine is beneficial.

2. TMS

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

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

Researchers believe that rTMS can alter the way neurons communicate. This process is known as neuroplasticity and allows the brain to form new connections and change how it functions.

TMS is FDA approved for treating depression can be treated in cases when other treatments like talk therapy and medication have not been successful. It has also been proven be effective in treating tinnitus as well as OCD. Researchers are also looking into the possibility of using it to treat Parkinson's and anxiety.

TMS has been proven to reduce depression in numerous studies, however not every person who receives it benefit. Before attempting this type of 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 may not be suitable for you.

A visit to your doctor may be beneficial if you're experiencing depression but aren't seeing any benefits from your current treatment. You may be a suitable candidate to try TMS or other forms of neurostimulation, however, you must test several antidepressants first before insurance coverage covers the cost. Contact us today to schedule a consultation If you're interested in knowing more. Our specialists will guide you through the process of the decision of whether TMS treatment is right for you.

3. Deep stimulation of the brain

A non-invasive therapy that rewires the brain circuitry could be effective in just one week for patients suffering from treatment resistant depression. Researchers have devised new methods that enable them to deliver high-dose magnetic pulses to the brain in a shorter period of time and at a frequency that is more manageable for patients.

Stanford neuromodulation therapy, which is currently available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences, uses MRI images to guide electrodes to send magnetic impulses to specific brain regions. In a recent study, Mitra and Raichle found that in three-quarters of patients with depression, the usual flow of neural activity from the anterior cingulate cortex and the anterior insula was reversed. With SNT, that flow 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 most appropriate location, neurosurgeons insert one or more wires, referred to as leads, inside the brain. The leads are connected to a neurostimulator that is implanted under the collarbone, which looks 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.

Certain psychotherapy treatments like cognitive behavior therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be done in a group setting or in one-on-one sessions with an experienced mental healthcare professional. Some therapists also provide Telehealth services.

Antidepressants remain a cornerstone of treatment for depression, but in recent times, there have been remarkable improvements in how quickly these drugs can alleviate depression 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 therapies employ electric or magnetic stimulation to stimulate the brain, for example electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complex procedures that require a doctor's supervision. In some instances, they could cause seizures or other serious adverse effects.

4. Light therapy

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

Light therapy works by mimicking sunlight, a key element of the biological clock referred to as the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and light therapy 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 are also using light therapy to treat a less severe type of depression referred to as winter blues. It's similar to SAD but affects fewer people and is only seen in months when there is the least amount of daylight. For the most effective results, they suggest you lie in front of the light therapy box for 30 minutes every morning while you are awake. Light therapy results are seen in one week, unlike antidepressants that can take a few weeks to begin working and can cause negative side effects, such as nausea or weight increase. It is also safe for pregnant women as well as older adults.

Researchers warn against using light therapy without the supervision of an expert in mental health or psychiatrist, as it can trigger manic episodes for people who suffer from bipolar disorders. Some people may experience fatigue within the first week due to the fact that light therapy can reset their sleep-wake pattern.

PCPs must be aware of new treatments that have been approved by the FDA However, they shouldn't neglect tried-and-true methods like antidepressants and cognitive behavioral therapy. "The pursuit of newer and better is exciting, but we must continue to focus on the most well-established treatments," Dr. Hellerstein tells Healio. He says PCPs should educate their patients on the benefits of new treatments as well as help them stick with their treatment plans. This can include arranging for transportation to their doctor's appointment or setting reminders for them to take medications and attend therapy sessions.