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Latest Depression Treatments

The good news is that if your depression does not improve after treatment with psychotherapy or antidepressants, new fast-acting drugs show promise for treating treatment-resistant depression.

SSRIs are the most common and well-known antidepressants. They work by altering the way that the brain processes serotonin, the chemical messenger.

Cognitive behavioral therapy (CBT) helps you to change negative thoughts and behavior like hopelessness. The NHS offers 8 to 16 sessions.

1. Esketamine

The FDA approved a new treatment for depression in March of 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is derived from the anesthetic the ketamine. This has been shown to be effective in severe depression. The nasal spray works with an oral antidepressant in order to treat depression that has not responded to standard medications. In one study, 70% of people suffering from treatment resistant depression who received this medication were able ways to treat depression respond well, which is a significantly higher response rate than just using an oral antidepressant.

Esketamine differs from standard antidepressants. It increases the levels of neurotransmitters in the brain that transmit messages between brain cells. The results don't come immediately. Patients generally feel better after a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine helps alleviate depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed these connections that are damaged by chronic stress and depression. It also seems to promote the development of neurons which can help reduce suicidal thoughts and thoughts.

Esketamine differs from other antidepressants due to the fact that it is delivered via nasal spray. This allows it to enter your bloodstream more quickly than oral or pill medication. The drug has been found to reduce depression symptoms within hours, and in some people the effects are instantaneous.

A recent study that tracked patients for 16 weeks found that not all who began treatment with esketamine had reached Remission. This is disappointing, but it's not surprising according to Dr. Amit A. Anand, a ketamine expert who was not involved with the study.

Esketamine is available only in private practice or clinical trials. Esketamine isn't a first-line option for treating depression. It is prescribed when SSRIs and SNRIs do not help a patient suffering from treatment-resistant depression. A patient's physician will determine if the disorder is refractory to treatment and discuss whether it is possible to use esketamine for treatment.

2. TMS

TMS uses magnetic fields to stimulate neurons in the brain. It is non-invasive, doesn't require anesthesia or surgery and has been proven to reduce depression for people who are not responding to medication or psychotherapy. It is also used to treat obsessive-compulsive disorder (OCD) and tinnitus.

TMS therapy for depression is typically delivered in a set of 36 daily treatments spread over six weeks. The magnetic pulses may be felt as pinpricks on the scalp. It can take time to become used to. Patients can return to their work and home immediately after a treatment. Each TMS session lasts between 3.5 minutes and 20 minutes, depending on the pattern of stimulation.

Researchers believe that rTMS functions by altering the way that neurons communicate with one another. This process is referred to as neuroplasticity. It allows the brain to create new connections and change how it operates.

At present, TMS is FDA-cleared to treat depression when other therapies such as talk therapy and medication, haven't worked. 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 disease as well as anxiety.

TMS has been proven to help with depression in a number studies, but not everyone who receives it will benefit. It is important that you undergo a thorough psychiatric and medical evaluation before trying this type of treatment. If you have a history of seizures or are taking certain medications, TMS might not be right for you.

A visit to your doctor can be beneficial if you're struggling with depression but not experiencing any positive results from the treatment you are currently receiving. You may be a candidate to try TMS or other forms of neurostimulation but you should try several antidepressants first before insurance coverage will cover the cost. Contact us today to set up a consultation if you're interested in learning more. Our specialists will assist you in the process of deciding whether TMS is the right option for you.

3. Deep stimulation of the brain

For people with treatment-resistant depression A non-invasive treatment that rewires the brain's circuits could be effective in as little as a week. Researchers have developed new techniques 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 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 specific areas in the brain. In a recent study, Mitra and Raichle found that in three-quarters of patients suffering from depression, the normal flow of neural activity from the anterior cingulate cortex to the posterior insula was interrupted. With SNT, that flow returned to normal within a week, which coincided with the lifting of their depression.

Deep brain stimulation (DBS) is a more invasive procedure, can produce similar effects in some patients. Neurosurgeons will perform a series tests to determine the most appropriate placement before implanting one or more leads inside the brain. The leads are connected to a neurostimulator that is implanted under the collarbone. It appears to be a heart-pacemaker. The device is able to deliver a continuous electric current through the leads. This alters the brain’s natural treatment depression anxiety circuitry, which reduces depression symptoms.

Some psychotherapy treatments, such as cognitive behavioral therapy and inter-personal therapy, may also relieve depression symptoms. Psychotherapy can be delivered in one-on-one sessions with an expert in mental health, or in a group setting. Some therapy providers offer telehealth.

Antidepressants remain a cornerstone of treatment for depression, and in recent times there have been some remarkable improvements in how quickly these drugs can 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 therapies employ electric or magnetic stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that require the supervision of a physician. In certain instances, they may cause seizures as well as other serious side effects.

4. Light therapy

Bright light therapy, which is working or sitting in front of a bright artificial light source, has been proven for a long time to treat major depression disorder through seasonal patterns (SAD). Studies show that it can ease symptoms like fatigue and sadness by controlling the circadian rhythms and enhancing mood. It also aids those suffering from depression treatment facility that is intermittent.

Light therapy works by mimicking sunlight, which is a crucial component of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is linked to mood and light therapy may rewire misaligned circadian rhythm patterns that may contribute to depression. Light can also reduce Melatonin levels and help restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression called winter blues. It is similar to SAD but is less common and only happens in the months with the least daylight. For the most effective results, they suggest that you sit in the light therapy box for 30 minutes each morning while awake. Light therapy results are seen in the space of a week, unlike antidepressants which can take weeks to kick in and may cause adverse effects like nausea or weight gain. It's also safe during pregnancy and in older adults.

Researchers advise against using light therapy under the supervision of a mental health professional or psychiatrist, as it can trigger manic episodes for people who suffer from bipolar disorders. It may also make some sufferers feel tired during the first week of treatment because it can alter their sleep and wake patterns.

PCPs must be aware of new treatments that have been approved by the FDA. However they shouldn't be ignoring tried-and-true methods like antidepressants or cognitive behavioral therapy. "The search for more effective and innovative treatments is exciting, but we should keep focusing on the most effective treatments," Dr. Hellerstein tells Healio. He suggests PCPs need to educate their patients on the advantages of new treatments and help them stick with their treatment plans. This could include arranging transportation to the doctor's appointment, or setting up reminders for patients to take their medication and attend therapy sessions.