Latest Depression Treatments

The good news what is the best treatment for anxiety and depression that, if your depression doesn't improve after psychotherapy and antidepressants, new fast-acting drugs offer promise in treating treatment-resistant depression.

SSRIs, or selective serotonin-reuptake inhibitors, are the most commonly prescribed and well-known antidepressants. These work by changing the way the brain uses serotonin as a chemical messenger.

Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behaviors such as despair. It's available through the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved a new treatment for depression in March 2019, a nasal spray 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 can be used with an oral antidepressant to treat postpartum depression treatment that hasn't responded to standard medication. In one study, 70% of people with depression that was resistant to treatment were given this drug did well - a more rapid response rate than using an oral antidepressant.

Esketamine acts differently than conventional antidepressants. It boosts the levels of naturally occurring chemical in the brain, called neurotransmitters. These chemicals transmit messages between brain cells. The results don't come immediately. Patients typically feel better within a few days, but the effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine improves depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed these connections which are weakened due to depression and stress. Additionally, it appears to stimulate the growth of neurons that can help reduce suicidal thoughts and feelings.

Another reason esketamine stands out from other antidepressants is the fact that it is administered via a nasal spray, which allows it to reach the bloodstream faster than a pill or oral medication would. The drug has been proven in studies to lessen depression symptoms within a few hours. In certain instances the effects may be almost immediate.

However the results of a study that followed patients over 16 weeks revealed that not all who began treatment with esketamine remained in the remission phase. This is disappointing but not surprising, according to Dr. Amit Anand, an expert on ketamine, who was not part of the study.

Esketamine is only available in private practice or in clinical trials. It is not considered a first-line treatment option for depression and is typically prescribed when SSRIs or SNRIs have not performed for a person suffering from treatment-resistant depression. The doctor will determine if the condition is not responding to treatment and then decide whether esketamine might be beneficial.

2. TMS

TMS employs magnetic fields to stimulate brain nerve cells. It is noninvasive, doesn't require anesthesia or surgery, and has been proven to improve depression in people who don't respond to medication or psychotherapy. It is also 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 similar to pinpricks placed on the scalp and can be a little difficult to get used to. After an appointment, patients can return to work or at home. Each TMS session lasts between 3.5 minutes and 20 minutes, based on the stimulation pattern.

Scientists believe rTMS works by altering the way neurons communicate with each other. This process, also known as neuroplasticity, allows the brain to form new connections and to modify its function.

Presently, TMS is FDA-cleared to treat depression when other treatments such as talk therapy and medication, haven't worked. It has also been shown to aid people suffering from tinnitus, OCD and pain. Scientists are currently examining whether it could also be used to treat Parkinson's disease.

TMS has been shown to reduce depression in numerous studies, but not everyone who receives it benefits. It is crucial to undergo a thorough psychiatric as well as medical evaluation before trying this kind of treatment. TMS is not suitable for you in the event of a history or a history of certain medications.

A visit to your doctor can be beneficial if you are experiencing depression but aren't getting any benefit from your current treatment. You could be eligible to participate in the TMS trial or other forms neurostimulation. However, you need to first try a variety of antidepressants before your insurance will cover the cost. Contact us today how to treatment depression schedule a consultation if you're interested in learning more. Our specialists will guide you through the process of determining if TMS is the best treatment for anxiety and depression choice for you.

3. Deep stimulation of the brain

For people suffering from depression that is resistant to treatment, a noninvasive therapy that rewires brain circuits can be effective within just one week. Researchers have developed new methods that deliver high-dose magnetic waves to the brain faster and on a schedule that is more manageable for patients.

Stanford neuromodulation therapy, now available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences, uses MRI images to guide electrodes to deliver magnetic pulses to specific brain regions. 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 anterior insula was disrupted. With SNT the flow of neural activity returned to normal within a week, and coincided with the lifting of their depression.

A more invasive technique called deep brain stimulation (DBS) can yield similar results in some patients. After several tests to determine the best place for the implant, neurosurgeons can insert one or more wires, called leads, in the brain. The leads are connected to a nerve stimulator implanted under the collarbone. It appears to be a heart-pacemaker. The device delivers continuous electrical current to the leads, which alters the brain's natural circuitry and reduces depression symptoms.

Certain psychotherapy therapies, such as cognitive behavioral therapy and inter-personal therapy can also help alleviate depression symptoms. Psychotherapy can be delivered in one-on-one sessions with a mental health professional, or in group settings. Some therapists also offer the option of telehealth services.

Antidepressants are still the primary treatment for depression. However, in recent times there have been some remarkable advancements in the speed at which these medications work to alleviate depression 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 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 the supervision of a physician. In some cases they can cause seizures as well as other serious adverse effects.

4. Light therapy

Bright light therapy, which entails working or sitting in front of a bright artificial light source, has been known for years to treat major depression disorder through seasonal patterns (SAD). Studies show that bright light therapy can decrease symptoms such as sadness and fatigue by boosting mood and regulating the circadian rhythms. It can also help those who suffer with depression that is not a continuous one.

Light therapy works by mimicking sunlight, which is a crucial component of the biological clock referred to as the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and light therapy can alter circadian rhythm patterns that can trigger depression. Light therapy can also decrease the production of melatonin and improve the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe form of depression called winter blues. It's similar to SAD but is less common and is only seen in months with the least daylight. They suggest sitting in front of a light therapy box every morning for 30 minutes while awake to get the maximum benefit. Light therapy results are seen in one week, unlike antidepressants which can take weeks to kick in and may trigger negative side effects, such as nausea or weight gain. It's also safe to use during pregnancy and for those who are older.

However, some research experts warn that one should never experiment living with treatment resistant depression light therapy without consulting of a psychiatrist or mental health professional because it could cause a manic episode in people with bipolar disorder. Some people may experience fatigue in the first week because light therapy can reset their sleep-wake pattern.

PCPs should be aware of the latest treatments that have been approved by the FDA. However, they shouldn't ignore tried-and-true methods like antidepressants or cognitive behavioral therapy. Dr. Hellerstein told Healio that while the search for newer and better treatments is exciting, we should focus on the most well-established treatments. He suggests that PCPs should be focusing on educating their patients about the benefits of new options and helping them adhere to their treatment plans. This could include offering transportation to their doctor's appointment or setting reminders for them to take medication and attend therapy sessions.