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Latest Depression Treatments

If your depression doesn't get better through psychotherapy and antidepressants new medications that work quickly may be able to treat treatment-resistant depression.

SSRIs, or selective serotonin reuptake inhibitors are the most commonly prescribed and well-known antidepressants. They alter how the brain processes serotonin, the chemical messenger.

Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviours such as despair. It's available on the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment for depression in March of 2019, a nasal spray 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 applied in conjunction with an oral antidepressant for depression that isn't responding to standard medications. In one study 70% of patients with treatment resistant depression who were given this drug were able to respond well, which is a significantly more rapid response rate than taking an oral antidepressant.

Esketamine acts differently than conventional antidepressants. It increases the amount of neurotransmitters that transmit messages between brain cells. The effects aren't immediately apparent. Patients generally feel better within a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine reduces symptoms of depression by strengthening brain cell connections. In animal studies, esketamine reversed these connections that are damaged through depression and chronic stress. It also appears to encourage the development of neurons which can decrease suicidal feelings and thoughts.

Esketamine is distinct from other antidepressants due to the fact that it is delivered by nasal spray. This allows it meds to treat anxiety and depression reach your bloodstream faster than pills or oral medications. The drug has been shown by studies to reduce depression symptoms within a few hours. In some instances the effects may be immediate.

A recent study that tracked patients for 16 weeks revealed that not all patients who began treatment with esketamine were in remission. This is disappointing but not unexpected, according Dr. Amit Anand, an expert on ketamine who was not involved in the study.

Esketamine is available only in clinical trials or in private practice. Esketamine isn't a first-line option to treat depression. It is prescribed when SSRIs and SNRIs fail to help a patient suffering from treatment-resistant depressive disorder. Doctors can determine if the disorder is resistant to treatment and then decide whether esketamine may be beneficial.

2. TMS

TMS employs magnetic fields to stimulate brain nerve cells. It is noninvasive and does not require anesthesia or surgery. It has been shown to aid people suffering from depression who have not responded to medication or psychotherapy. It is also used to treat obsessive compulsive disorder (OCD) and tinnitus.

For depression, TMS therapy is typically administered as a series of daily treatments over six weeks. The magnetic pulses may feel like pinpricks in the scalp. It may take some time to become used to. After a treatment, patients can return to work or go home treatment for depression. Each TMS session can last between 3.5 minutes and 20 minutes, based on the stimulation pattern.

Researchers believe that rTMS functions by altering the way neurons communicate with each other. This process is known as neuroplasticity. It allows the brain to create new connections and change the way it functions.

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 aid people suffering from tinnitus, OCD and pain. Researchers are also investigating the possibility of using it to treat Parkinson's disease and anxiety.

Although a number of different studies have proven that TMS can help with depression however, not everyone who receives the treatment benefits. It is important that you have a thorough psychiatric and medical evaluation before trying this type of treatment. TMS is not a good option when you have a history of or a history of certain medications.

Talking 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 candidate for a trial of TMS or other forms of neurostimulation, but you should try various antidepressants before insurance coverage can cover the cost. Contact us today to arrange a consultation to learn more about. Our experts will assist you through the process of deciding if TMS treatment is suitable for you.

3. Deep stimulation of the brain

For those suffering from treatment-resistant depression, a noninvasive therapy that resets brain circuitry can be effective in just one week. 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 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 It uses MRI images to direct electrodes to deliver magnetic pulses to specific areas of the brain. In a recent study Mitra and Raichle discovered that in three-quarters of people with depression, the usual flow of neural activity from the anterior cingulate cortex and the anterior insula was interrupted. SNT returned that flow back to normal within a couple of days, coinciding perfectly with the easing of depression.

A more invasive procedure called deep brain stimulation (DBS) can produce similar results in certain patients. Neurosurgeons will perform a series tests to determine the most appropriate placement before implanting one or more leads in the brain. The leads are connected to a neurostimulator implanted beneath the collarbone, which appears like a heart pacemaker. The device provides a continuous electric current through the leads. This alters the brain’s natural treatment for depression circuitry, which reduces depression symptoms.

Certain psychotherapy therapies like cognitive behavioral therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be conducted in an environment of group or one-on-one sessions with an experienced mental health professional. Some psychotherapists provide telehealth.

Antidepressants remain a cornerstone of treatment for depression, but in recent years there have been some 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 therapies use 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 must be done under a physician's care. In certain instances, they may cause seizures or other serious adverse side effects.

4. Light therapy

Bright light therapy involves sitting or standing in front of an artificially 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 suggests that bright light therapy can reduce symptoms such as sadness and fatigue by improving mood and controlling circadian rhythm patterns. It can also help people who suffer from depression, which is intermittently present.

Light therapy mimics sunlight which is an essential component of a biological clock called suprachiasmatic (SCN). The SCN is linked to mood, and light therapy can rewire circadian rhythm patterns which can trigger depression. Additionally, light therapy can reduce melatonin levels and improve the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression known as winter blues, which is similar to SAD but is less common and only happens in the months when there is less daylight. They recommend sitting in front of a light therapy box each morning for 30 minutes while awake to reap the most benefits. Light therapy results are seen in the space of a week, unlike antidepressants that can take a few weeks to begin working and may cause adverse effects like nausea or weight gain. It is also safe for pregnant women and older adults.

However, some researchers warn that one should not experiment with light therapy without consulting of psychiatrists or a mental health professional, as it can trigger a manic episode in those with bipolar depression treatment disorder. It can also make people feel tired during the first week of treatment as it could alter their sleep deprivation treatment for depression-wake patterns.

PCPs should be aware of new treatments that have been approved by the FDA however, they shouldn't neglect tried-and-true methods such as 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 teaching their patients about the benefits of new options and helping patients adhere to their treatment strategies. This may include providing transportation to the doctor's office, or setting up reminders for them to take their medication and attend therapy sessions.