What Do You Know About Latest Depression Treatments
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 resistant to treatment.
SSRIs which are also known as selective serotonin reuptake inhibitors, are the most frequently prescribed and well-known antidepressants. They work by altering the way the brain uses serotonin which is a chemical messenger.
Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy assists you in changing negative thoughts and behaviors, such as despair. It is available on the NHS for 8 to 16 sessions.
1. Esketamine
The FDA approved a new treatment for depression in March 2019 nasal spray known as esketamine (brand name Spravato). It is derived from the anesthetic ketamine. This has been shown to be effective in cases of severe depression. The nasal spray is used in conjunction with an oral antidepressant for depression that hasn't responded to standard medication. In one study, 70% of people with treatment resistant depression who received this medication responded well - a much greater response rate than using an oral antidepressant.
Esketamine is different from traditional antidepressants. It boosts the levels of naturally occurring chemical in the brain, referred to as neurotransmitters. They transmit messages between brain cells. The results aren't immediate. Patients typically feel a little better after a few days however, the effects last for a longer time than with SSRIs or SNRIs. Those can take weeks or even months to show results.
Researchers believe that esketamine improves depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed these connections which are weakened through depression and chronic stress. It also appears to promote 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 through a nasal spray that allows it to get into the bloodstream more quickly than pills or oral medication would. It has been demonstrated by studies to decrease depression symptoms within a few hours. In some instances the effects can be instantaneous.
A recent study that tracked patients for 16 weeks revealed that not all patients who started treatment with esketamine had reached the remission phase. This is disappointing, but it's not surprising according to Dr. Amit A. Anand, a ketamine expert who was not part of the study.
Esketamine is currently only available in private practice or clinical trials. It is not considered a first-line treatment for depression and is typically prescribed only when SSRIs or SNRIs haven't performed for a person suffering from treatment-resistant depression. A patient's doctor can determine if their condition is resistant to treatment and determine if esketamine could be beneficial.
2. TMS
TMS uses magnetic fields to stimulate brain nerve cells. It is noninvasive, does not require anesthesia or surgery, and has been shown to improve depression in people who are not responding to medication or psychotherapy. It is also used to treat obsessive-compulsive disorders and tinnitus (ringing in the ear).
TMS treatment for depression is usually given in a series of 36 daily treatments spread out over six weeks. The magnetic treatment for depression pulses feel similar to a series of pinpricks on the scalp and could be a little difficult to get used to. After the treatment, patients are able to return to work or go home. Based on the type of stimulation employed, each TMS session can last between 3.5 and 20 minutes.
Scientists believe rTMS works by altering the way that neurons communicate with each other. This process is known as neuroplasticity, and it lets the brain form new connections and change the way it operates.
TMS is FDA approved to treat depression in cases that other treatments such as medication and talk therapy have not worked. It has also been shown to aid those suffering from tinnitus, OCD and pain. Scientists are also exploring the possibility of using it to treat Parkinson's disease and anxiety.
TMS has been shown to help with depression in several studies, however not every person who receives it benefits. Before attempting this type of treatment, it's important to undergo an exhaustive mental and medical evaluation. TMS is not for you when you have a history of or a history of certain medications.
A visit to your doctor could be beneficial if you are struggling with depression but not getting any benefit from your current treatment. You could be a good candidate for a trial of TMS or other forms of neurostimulation, however, you must test several antidepressants before insurance coverage will cover the cost. If you're interested in knowing more about these life-changing treatments, contact us today for a consultation. Our experts will assist you in the decision of whether TMS treatment is right for you.
3. Deep stimulation of the brain
A non-invasive treatment that resets the brain's circuitry could be effective in as little as one week for patients suffering from treatment-resistant depression. Researchers have come up with new methods that allow them to deliver high-dose electromagnetic pulses to the brain in a shorter period of time and on a schedule that is more manageable for patients.
Stanford neuromodulation therapy (SNT) SNT, that is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic, uses MRI imaging to guide electrodes which send magnetic pulses to targeted areas of the brain. In a recent study Mitra and Raichle discovered that in three-quarters of people who suffer from depression, the typical flow of neural activity from the anterior cingulate cortex to the posterior insula was interrupted. SNT returned the flow back to normal within a couple of days, and it was perfectly timed with the easing of depression.
A more invasive technique called deep brain stimulation (DBS) can yield similar results in certain patients. Neurosurgeons conduct a series of tests to determine the best placement before implanting one or more leads inside the brain. The leads are connected with the neurostimulator. It is placed beneath the collarbone and looks like the appearance of a pacemaker. The device provides an uninterrupted electric shock treatment for depression treatment for depression (click through the up coming post) current through the leads. This alters the brain's natural circuitry, reducing depression symptoms.
Certain psychotherapy treatments can help alleviate depression symptoms, including cognitive behavioral therapy and interpersonal therapy. Psychotherapy can be provided in one-on-one sessions with an expert in mental health, or in group settings. Some therapists also provide the option of telehealth services.
Antidepressants are still the primary treatment for depression, and in recent years, there have been remarkable advances in how quickly these medications can work to lift depressive 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 treatments 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 the supervision of a physician. In certain instances, they may cause seizures as well as other serious adverse side effects.
4. Light therapy
Bright light therapy consists of sitting or standing in front of a bright light source. This treatment has been used for many years to treat seasonal depression and major depressive disorder (SAD). Research has shown that it can relieve symptoms like fatigue and sadness by regulating circadian rhythm patterns and enhancing mood. It also aids people who suffer from depression that is intermittently present.
Light therapy works by mimicking sunlight, which is a major component of the biological clock called the suprachiasmatic nucleus (SCN). The SCN is associated with mood, and light therapy may alter the patterns of circadian rhythms that can contribute to depression. Light therapy can also lower melatonin and restore the function of neurotransmitters.
Some doctors are also using light therapy to treat a less severe type of depression referred to as winter blues, which is similar to SAD but affects fewer people and is only seen in months with the least daylight. They recommend sitting in front of a light therapy device each morning for 30 minutes while awake to get the maximum benefit. Light therapy can produce results within the space of a week, unlike antidepressants that can take a long time to kick in and may trigger side effects such as nausea or weight increase. It is also suitable for pregnant women and older adults.
Researchers advise against using light therapy under the supervision of a mental health professional or psychiatrist, because it can trigger manic episodes in people who suffer from bipolar disorders. It may also make some people feel tired in the first week of treatment as it could alter their sleep-wake patterns.
PCPs must be aware of new treatments that have been approved by the FDA, but they shouldn't be ignoring tried-and-true approaches like antidepressants or cognitive behavioral therapy. "The pursuit of newer and better treatments is exciting, but we should keep focusing on the most effective therapies," Dr. Hellerstein informs Healio. He says that PCPs should concentrate on educating their patients on the benefits of new treatments and assisting them adhere to their treatment plans. This can include providing transportation to the doctor's office, or establishing reminders to patients to take their medications and attend therapy sessions.