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Latest Depression Treatments

If your depression doesn't improve by taking antidepressants or psychotherapy, new drugs that act quickly may be able to treat treatment-resistant depression.

SSRIs are the most popular and well-known antidepressants. They affect the way that the brain utilizes serotonin.

Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behaviours, such as hopelessness. It's available on 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 from 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 to treat depression that hasn't responded to standard medications. In one study 70% of patients with treatment resistant depression who were given this drug did well - a higher response rate than just using an oral antidepressant.

Esketamine differs from standard antidepressants. It raises the levels of neurotransmitters in the brain 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 helps reduce depression symptoms through strengthening connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections which can be found in depression and chronic stress. Additionally, it appears to boost the development of neurons that help to reduce suicidal ideas and feelings.

Another reason esketamine stands out from other antidepressants is that it is delivered through an nasal spray, which allows it to reach the bloodstream more quickly than pills or oral medication can. The drug has been proven in studies to lessen depression symptoms within a matter of hours. In some cases the effects may be instantaneous.

A recent study that tracked patients for 16 weeks revealed that not all patients who started treatment with esketamine were in 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 only available in private practice or in clinical trials. Esketamine isn't a first line treatment for depression and anxiety-line treatment for depression. It is prescribed when SSRIs and SNRIs do not be effective for a patient suffering from treatment-resistant depression. The doctor will determine if the disorder is resistant to treatment and then decide whether esketamine could be beneficial.

2. TMS

TMS makes use of magnetic fields to stimulate nerve cells in the brain. It is noninvasive, does not require anesthesia or surgery, and has been proven to reduce depression treatment during pregnancy in those who do not respond to medication or psychotherapy. It can also be used to treat obsessive-compulsive disorder (OCD) and tinnitus.

TMS therapy for depression is usually given in a set of 36 daily treatments spread over six weeks. The magnetic pulses feel like a series of pinpricks on the scalp, and may require some time to get used to. Patients are able to return to work and home immediately following a treatment. Based on the stimulation pattern used the session TMS session can last between 3.5 and 20 minutes.

Researchers believe that rTMS functions by altering the way that neurons communicate with each other. This process, known as neuroplasticity, enables the brain to create new connections and alter its functions.

Presently, TMS is FDA-cleared to help with depression when other treatments like talk therapy or medication, have not worked. It has also been proven to help people with tinnitus, OCD and pain. Researchers are examining whether it can be used to treat Parkinson's disease.

Although a number of different studies have found that TMS can improve depression treatment guidelines but not everyone who gets the treatment experiences a benefit. It is crucial to have a thorough psychiatric and medical examination prior to attempting this treatment. If you have any history of seizures or are taking certain medications, TMS might not be the best treatment for severe depression option for you.

A visit to your doctor could be beneficial if you are struggling with depression but not seeing any benefits from the treatment you are currently receiving. You could be eligible to participate in an TMS trial or other forms of neurostimulation. However, you must first try several antidepressants before your insurance will cover the cost. If you are interested in learning more about these life-changing treatments, contact us today for a consultation. Our specialists will guide you through the process of determining if TMS treatment is right for you.

3. Deep stimulation of the brain

A noninvasive therapy that resets the brain circuitry could be effective in just one week for those suffering from treatment resistant depression. Researchers have come up with new methods that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter period of time and on a schedule that is more adaptable 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 send magnetic pulses into targeted areas of the brain. In a recent study Mitra and Raichle found that in three-quarters (75%) of patients 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 few days, coinciding perfectly with the end of their depression.

A more invasive technique called deep brain stimulation (DBS) can produce similar results for some patients. After an array of tests to determine the optimal place for the implant, neurosurgeons can insert one or more wires, known as leads, inside the brain. The leads are connected with an electrical stimulation device, which is placed beneath the collarbone and looks like an electronic pacemaker. The device provides an uninterrupted electric current through the leads. This alters the brain’s natural circuitry, reducing depression symptoms.

Some psychotherapy treatments like cognitive behavior therapy and inter-personal therapy, can also help alleviate depression symptoms. Psychotherapy can be done in groups or in one-on-one sessions with an experienced mental health professional. Therapists may also offer the option of telehealth services.

Antidepressants are the mainstay of depression treatment. In recent times, however there have been some notable advancements in the speed at which they can help alleviate 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, such as electroconvulsive treatment (ect for treatment resistant depression [click this link]) or repetitive transcranial magnetic stimulation (rTMS) utilize magnetic or electric stimuli to stimulate the brain. These are more complex procedures that require a doctor's supervision. In some instances, they could cause seizures and other serious adverse side effects.

4. Light therapy

Bright light therapy, which involves 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). Research suggests that bright light therapy can help reduce symptoms such as sadness and fatigue by improving mood and controlling circadian rhythms. It can also help people who experience depression that occurs and disappears.

Light therapy mimics sunlight, which is a key element of a biological clock referred to as suprachiasmatic (SCN). The SCN is associated with mood and light therapy may change the patterns of circadian rhythms which can cause depression. Light can also reduce the production of melatonin and improve the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe kind of depression called winter blues, which is similar to SAD but affects fewer people and only happens in the months when there is less daylight. They suggest sitting in front of a light therapy box every morning for 30 minutes while awake to gain the most benefit. Contrary to antidepressants, which may take weeks to work and can often cause side effects like weight gain or nausea the light therapy method can deliver results within one week. It's also safe to use during pregnancy and in older adults.

Researchers warn against using light therapy under the supervision of an expert in mental health or psychiatrist, because it can cause manic episodes in those who suffer from bipolar disorders. It could also make people feel tired during the first week of treatment due to the fact that it could alter their sleep-wake patterns.

PCPs need to be aware of new treatments that have been approved by FDA. However they shouldn't dismiss the tried-and-true techniques like antidepressants or cognitive behavioral therapy. "The pursuit of newer and better is exciting, but we must continue to focus on the most well-established treatments," Dr. Hellerstein says to Healio. He says that PCPs should focus on teaching their patients about the benefits of new treatments and assisting patients adhere to their treatment plans. This can include providing transportation to the doctor's office or setting up reminders to patients to take their medication and attend therapy sessions.