The One Latest Depression Treatments Mistake That Every Newbie Makes
Latest Depression Treatments
If your depression doesn't improve by taking antidepressants or psychotherapy, new drugs that act quickly could be able to treat depression that is resistant to treatment.
SSRIs also known as selective serotonin reuptake inhibitors, are the most frequently prescribed and well-known antidepressants. These work by changing how the brain processes serotonin as a chemical messenger.
Cognitive behavioral therapy (CBT) helps you to change negative thoughts and behavior, such as hopelessness. It's available through the NHS for 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 the anesthetic, the ketamine. This has been shown to be effective in severe depression. The nasal spray is utilized in conjunction with an oral antidepressant for depression that isn't responding to standard medications. In one study 70% of patients with depression that was resistant to treatment were given this drug did well - a higher response rate than just taking an oral antidepressant.
Esketamine is different from conventional antidepressants. It increases the levels of neurotransmitters in the brain that transmit messages between brain cells. The effects aren't immediate. Patients usually feel better after a few days, but the effects last longer than SSRIs or SNRIs. Those can take weeks to months to show results.
Researchers believe that esketamine improves depression symptoms by strengthening 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 promote the development of neurons that could help reduce suicidal thoughts and feelings.
Esketamine differs from other antidepressants due to the fact that it is delivered by nasal spray. This allows it to enter your bloodstream more quickly than pill or oral medication. The drug has been proven in studies to lessen depression symptoms within a couple of hours. In some instances, the effects can be immediate.
A recent study that tracked patients for 16 weeks revealed that not all patients who started treatment with esketamine were actually in the remission phase. This is not surprising, according to Dr. Amit Anand, an expert on ketamine who was not part of the study.
At present, esketamine is only available through the clinical trial program or private practice. It is not considered to be a first-line treatment for depression and is typically prescribed when SSRIs or SNRIs have not been effective for a patient suffering from treatment-resistant depression. Doctors can determine if the condition is not responding to treatment, and then determine whether esketamine may be beneficial.
2. TMS
TMS utilizes magnetic fields in order to stimulate brain nerve cells. It is non-invasive and does not require surgery or anesthesia. It has been proven to aid people suffering from depression who haven't responded to medications or psychotherapy. It is also used to treat the disorder of obsessive compulsiveness and tinnitus (ringing in the ears).
TMS treatment for depression is usually delivered in a series 36 daily treatments spread over six weeks. The magnetic pulses can be felt as pinpricks on the scalp. It can take time to become accustomed to. After a treatment, patients can return to work or at home. Depending on the stimulation pattern used, each TMS session can last between 3.5 and 20 minutes.
Researchers believe that rTMS can alter the way neurons communicate. This process, also known as neuroplasticity, enables the brain to form new connections and to modify its function.
TMS is FDA approved to treat depression in situations where other therapies such as medications and talk therapy have not worked. It has also been proven to be effective in treating tinnitus as well as OCD. Researchers are also investigating the possibility of using it to treat Parkinson's disease as well as anxiety.
TMS has been proven to reduce depression in numerous studies, but not everyone who receives it will benefit. Before you embark on this treatment, it is essential to undergo an exhaustive mental and medical evaluation. TMS is not suitable for you when you have a history of or are taking certain medications.
If you have been suffering from depression and aren't getting the benefits from your current treatment plan, a conversation with your psychiatrist may be helpful. You could be eligible for an TMS trial or other forms neurostimulation. However, you must first try several antidepressants before your insurance company will cover the cost. If you are interested in learning more about these life-changing treatments, call us now for a free consultation. Our specialists will help you through the process of deciding whether TMS is the best option for you.
3. Deep brain stimulation
A non-invasive therapy that rewires the brain's circuitry could be efficient in just one week for those suffering from treatment-resistant depression. Researchers have developed new techniques that permit them to deliver high-dose magnetic impulses to the brain in a shorter time and on a schedule 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 direct electrodes that transmit magnetic pulses to the targeted areas of the brain. In depression support groups Iam Psychiatry conducted recently, Mitra & Raichle found in three quarters of patients suffering from depression that the normal flow of neural activity was reversed from the anterior cortex to the anterior cortex. With SNT, that flow returned to normal within a week, and coincided with a lifting of their depression.
Deep brain stimulation (DBS), an invasive procedure, can produce similar effects in some patients. After an array of tests to determine the optimal place for the implant, neurosurgeons can insert one or more wires, called leads, inside the brain. The leads are connected by a neurostimulator, which is inserted under the collarbone and appears like the appearance of a pacemaker. The device provides an uninterrupted electric current through the leads. This alters the brain's natural circuitry, reducing depression symptoms.
Some psychotherapy treatments may also help relieve depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can take place in a group setting or in one-on-one sessions with an experienced mental health professional. Some therapists offer telehealth.
Antidepressants are still the primary treatment for depression, and in recent years there have been significant improvements in how quickly these medications work to reduce 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, like electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that need to be performed under the supervision of a physician. In some cases they can cause seizures as well as other serious adverse effects.
4. Light therapy
Bright light therapy consists of sitting or standing in front of a bright light source. This therapy has been used for a number of years to treat seasonal depression as well as major depressive disorder (SAD). Research has shown that bright light therapy can reduce symptoms such as sadness and fatigue by boosting mood and regulating the circadian rhythms. It also aids people who suffer from depression that is intermittently present.
Light therapy works by mimicking sunlight, a key element of the biological clock called the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and light therapy can rewire misaligned circadian rhythm patterns that may contribute to depression. Light therapy can also decrease melatonin and restore the function of neurotransmitters.
Some doctors employ light therapy to treat winter blues. This is a milder type of depression that is similar to SAD however it has fewer people affected and is most prevalent in the months in which there is the least amount of daylight. To get the most effective results, they recommend that you lie in the box for 30 minutes every morning while you are awake. Light therapy can produce results within the space of a week, unlike antidepressants which can take weeks to kick in and may trigger negative side effects, such as nausea or weight gain. It is also safe for pregnant women as well as older adults.
Researchers caution against using light therapy under the supervision of an expert in mental health or psychiatrist, because it could trigger manic episodes in 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 patterns.
PCPs should be aware of new treatments that have been approved by the FDA However, they shouldn't overlook tried-and-true techniques like antidepressants and cognitive behavioral therapy. Dr. Hellerstein told Healio that although the quest for better and newer treatments is exciting, we should focus on the most established treatments. He says PCPs should be focusing on informing their patients about the benefits of new options and helping them stick to their treatment strategies. This can include providing transportation to the doctor's office or setting reminders to patients to take their medications and attend therapy sessions.