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Latest Depression Treatments

The positive side is that if your depression doesn't improve after psychotherapy and antidepressants, new drugs that are fast-acting offer promise in treating treatment-resistant depression.

SSRIs are the most popular and well-known antidepressants. These antidepressants work by altering the way that the brain utilizes serotonin.

Cognitive behavioral therapy (CBT) helps you to change negative thoughts and behaviours such as despair. The NHS offers 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment for depression in March 2019 nasal spray known as esketamine (brand name Spravato). It is derived from the anesthetic ketamine. It has been proven to be effective in severe depression. The nasal spray is applied in conjunction with an oral antidepressant to treat depression that isn't responding to standard medication. In one study, 70% of people suffering from treatment resistant depression who received this medication did well - a higher response rate than just taking an oral antidepressant.

Esketamine differs from standard antidepressants. It increases the amount of neurotransmitters in the brain that transmit messages between brain cells. The results don't come immediately. Patients usually feel better after a couple of days but the effects last for a longer time than with SSRIs or SNRIs. Those can take anywhere from weeks to months to begin to show effects.

Researchers believe that esketamine improves depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed these connections that can be broken down through depression and chronic stress. In addition, it seems to promote the development of neurons that could help reduce suicidal thoughts and feelings.

Another reason esketamine is different from other antidepressants is the fact that it is delivered via an nasal spray which allows it to get into the bloodstream more quickly than pills or oral medication could. It has been proven to reduce depression symptoms within a matter of hours, and in some individuals the effects are immediate.

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

Esketamine is currently only available through the clinical trial program or in private practice. It is not considered to be a first-line treatment option for depression, and is typically prescribed when SSRIs or SNRIs haven't performed for a person suffering from treatment-resistant depression. A patient's physician can determine if their condition is resistant to treatment and determine if esketamine could be beneficial.

2. TMS

TMS utilizes magnetic fields to stimulate neurons in the brain. It is non-invasive and does not require surgery or anesthesia. It has been proven to help patients suffering from depression who have not been able to respond to medication or psychotherapy. It has also been used to treat obsessive-compulsive disorder and tinnitus (ringing in the ears).

For depression, TMS therapy is typically given as a series of daily treatments over six weeks. The magnetic pulses feel like a series of pinpricks on the scalp, and may take a bit of getting used to. After a treatment, patients can return to work or at home. Depending on the stimulation pattern employed and the stimulation pattern used, each TMS session can last between 3.5 and 20 minutes.

Researchers believe that rTMS functions by changing the way neurons communicate with one another. This process, referred to as neuroplasticity allows the brain establish new connections and alter its functions.

Currently, TMS is FDA-cleared to treat depression when other treatments, including talk therapy and medications, haven't succeeded. It has also been proven to aid those suffering from tinnitus, OCD and pain. Researchers are also investigating the possibility of using it to treat Parkinson's and anxiety depression treatment.

Although a number of different studies have found that TMS can improve depression but not everyone who gets the treatment will experience a positive effect. It is crucial to undergo a thorough psychiatric as well as medical evaluation before trying this treatment. If you have an history of seizures or are taking certain medications, TMS may not be the best option for you.

If you've been suffering from depression and are not seeing the benefits of your current treatment plan, a conversation with your psychiatrist might be beneficial. You may be a candidate for a trial of TMS or other forms of neurostimulation, but you need to try several antidepressants before insurance coverage will cover the cost. Contact us today to schedule a consultation if you're interested in learning more. Our specialists will help you through the process of determining whether TMS is the best option for you.

3. Deep stimulation of the brain

A non-invasive treatment that resets 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 methods that permit them to deliver high-dose magnetic pulses to the brain in a shorter period of time and at a frequency 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 makes use of MRI imaging to guide electrodes which send magnetic pulses to the targeted areas of the brain. In a recent study, Mitra & Raichle found in three quarters of patients with depression the normal neural activity was reversed from the anterior cortex to the anterior isola. With SNT, that flow returned to normal within a week, and coincided with a reduction in their depression.

A more invasive procedure called deep brain stimulation (DBS) can produce similar results in some patients. Neurosurgeons perform a series of tests to determine the most appropriate placement before implanting one or more leads in the brain. The leads are connected by a neurostimulator, which is implanted beneath the collarbone. It appears like an electronic pacemaker. The device delivers an ongoing electric current through the leads. This alters the brain’s natural ways to treat depression and anxiety circuitry, reducing depression symptoms.

Some psychotherapy treatments like cognitive behavioral therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be offered in one-on-one sessions with a mental health professional, or in a group setting. Some therapy providers offer online health.

Antidepressants are still the cornerstone of depression treatment. In recent times, however there have also been notable advancements in the speed at which they can alleviate 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 therapies employ magnetic or electric stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complicated procedures that need to be performed under a physician's care. In some cases they can trigger seizures or 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 utilized for many years to treat seasonal depression and major depressive disorder (SAD). Studies show that it can alleviate symptoms like fatigue and sadness by controlling circadian rhythm patterns and enhancing mood. It also aids people who experience depression that comes and goes.

Light therapy mimics sunlight which is a major component of a biological clock called suprachiasmatic (SCN). The SCN is linked to mood and light therapy has the ability to rewire misaligned circadian rhythm patterns that may contribute to depression. Additionally, light therapy can lower melatonin levels, and restore the function of neurotransmitters.

Some doctors use light therapy to treat winter blues. This is a milder version of depression that is similar to SAD however it is more common and is most prevalent in the seasons when there is the least amount of sunlight. They recommend sitting in front of a light therapy box every Morning Depression Treatment for 30 minutes while awake to get the most benefits. Light therapy results are seen in a 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 and older adults.

Researchers warn against using light therapy under the supervision of a mental health professional or psychiatrist, because it can trigger manic episodes for people who suffer from bipolar disorders. It can also make people feel tired in the first week of treatment due to the fact that it can alter their sleep and wake patterns.

PCPs should be aware of new treatments that have been approved by the FDA, but they shouldn't overlook tried-and-true techniques such as antidepressants and cognitive behavioral therapy. Dr. Hellerstein told Healio that while the search for newer and better treatments is exciting, we should be focusing on the most well-established therapies. He says PCPs should concentrate on informing their patients about the benefits of the latest treatments and help patients adhere to their treatment plans. That can include arranging for transportation to their doctor's appointment or setting reminders for them to take their medication and attend therapy sessions.