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Latest Depression Treatments The good news 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 which are also known as selective serotonin reuptake inhibitors, are the most commonly prescribed and well-known antidepressants. They work by altering the way that the brain processes serotonin. Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy, helps you to change negative thoughts and behavior such as hopelessness. The NHS offers 8 to 16 sessions. 1. Esketamine The FDA approved a new treatment for depression in March of 2019 nasal spray known as esketamine (brand name Spravato). It is derived from the anesthetic ketamine that has been proven to be effective in cases of severe of depression. The nasal spray is utilized in conjunction with an oral antidepressant for depression that isn't responding to standard medications. In one study, 70 percent of people with depression that was resistant to treatment treated with the drug showed good results with a much greater response rate than just 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 typically feel a little better after a few days but the effects last longer than with SSRIs or SNRIs. Those can take anywhere from weeks to months to show results. Researchers believe that esketamine reduces symptoms of depression through strengthening brain cell connections. In animal studies, esketamine reversed these connections that can be broken down through depression and chronic stress. It also seems to promote the growth of neurons that can help reduce suicidal thoughts and thoughts. Another reason why esketamine is distinct from other antidepressants is that it is delivered through an nasal spray, which allows it to enter the bloodstream more quickly than a pill or oral medication could. It has been demonstrated by studies to reduce depression symptoms within a few hours. In some instances, the effects can be immediate. However, the results of a recent study that tracked patients for 16 weeks showed that not everyone who started treatment with esketamine continued to be in the remission phase. This is a bit disappointing, but not surprising, according to Dr. Amit A. Anand an expert in ketamine who was not involved with the study. Esketamine is currently only available through an experimental clinical trial program or private practices. Esketamine is not a primary treatment for depression. It is prescribed when SSRIs and SNRIs fail to be effective for a patient suffering from treatment-resistant depressive disorder. Doctors can determine if the condition is not responding to treatment, and then determine whether esketamine might 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 been able to respond to medication or psychotherapy. It can also be used to treat obsessive-compulsive disorder (OCD) and tinnitus. For depression, TMS therapy is typically delivered as a series of daily sessions spread over six weeks. The magnetic pulses may feel like pinpricks in the scalp. It could take some time to get used to. Patients are able to return to work and home immediately after a treatment session. Based on the stimulation pattern used and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes. Scientists believe that rTMS changes the way that neurons communicate. This process is referred to as neuroplasticity. It allows the brain to form new connections and change the way it operates. TMS is FDA approved to treat depression in situations that other treatments such as medication and talk therapy have not worked. It has also been proven to help people with tinnitus, OCD and pain. Researchers are also looking into the possibility of using it to treat Parkinson's disease and anxiety. While a variety of studies have found that TMS can improve depression but not everyone who gets the treatment will experience a positive effect. Before beginning this treatment, it is important to undergo a thorough medical and psychiatric examination. TMS is not suitable for you when you have a history of or a history of certain medications. Talking to your doctor may be beneficial if you are suffering from depression, but are not experiencing any positive results from the treatment you are currently receiving. You could be eligible to participate in the TMS trial or other forms of neurostimulation. However, you need to first try several antidepressants before your insurance company will cover the cost. If you're interested in knowing more about these life-changing treatments, call us today for a consultation. Our experts will assist you in determining if TMS treatment is the right one for you. 3. Deep stimulation of the brain For those suffering from treatment-resistant depression, a non-invasive treatment that rewires brain circuits can be effective within as little as a week. Researchers have developed new techniques that allow them to deliver high-dose magnetic impulses to the brain in a shorter time and on a schedule that is more adaptable for patients. Stanford neuromodulation therapy, which is now 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 impulses to specific areas of the brain. In a recent research, Mitra & Raichle found that in three quarters of patients with depression that the normal flow of neural activity was disrupted, shifting from the anterior cortex to the anterior isola. With SNT the flow of neural activity returned to normal within a week, which coincided with a lifting of their depression. A more invasive procedure called deep brain stimulation (DBS) can produce similar results in some patients. Neurosurgeons will perform a series tests to determine the most appropriate location before implanting one or more leads inside the brain. The leads are connected with a neurostimulator, which is placed beneath the collarbone and looks like an electronic pacemaker. The device is able to deliver an uninterrupted electric current through the leads. This alters the brain’s natural circuitry, reducing depression symptoms. Some psychotherapy treatments may also aid in reducing depression symptoms, such as cognitive behavior therapy and interpersonal therapy. Psychotherapy can be offered in one-on-one sessions with a mental health professional, or in a group setting. Therapists may also offer the option of telehealth services. Antidepressants remain a cornerstone of treatment for depression, and in recent years there have been significant advances in how quickly these drugs can reduce 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 therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS) make use of electric or magnetic stimuli to stimulate the brain. These are more complex procedures that require the supervision of a physician. In Iampsychiatry , they could cause seizures or other serious adverse effects. 4. Light therapy Bright light therapy, which is sitting or working in front of an artificial light source, has been used for years to treat major depression disorder through seasonal patterns (SAD). Research has shown that bright light therapy can decrease symptoms like fatigue and sadness by improving mood and regulating circadian rhythms. It also aids people who suffer from depression that comes and goes. Light therapy mimics sunlight which is a major component of a biological clock known as suprachiasmatic (SCN). The SCN is linked to mood, and light therapy may alter circadian rhythm patterns that can trigger 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. It's similar to SAD but affects fewer people and only occurs in the months when there is the least amount of daylight. To achieve the best results, they suggest that you sit in the box for 30 minutes each morning while awake. Unlike antidepressants, which can take weeks to kick in and can cause adverse effects such as nausea or weight gain light therapy can provide results in just one week. It's also safe during pregnancy and for older adults. Researchers warn against using light therapy without the supervision of a mental health professional or psychiatrist, because it may cause manic episodes in those with bipolar disorders. It can also make sufferers feel tired during the first week of treatment due to the fact that it can alter their sleep and wake patterns. PCPs must be aware of the latest treatments that have been approved by FDA. However they shouldn't be ignoring traditional methods such as antidepressants and cognitive behavioral therapy. “The search for newer and better is exciting, but we must continue to focus on the most well-established treatments,” Dr. Hellerstein tells Healio. He says PCPs should concentrate on educating their patients about the benefits of the latest treatments and help them stick to their treatment plans. This may include providing transportation to the doctor's office, or setting up reminders for them to take their medications and attend therapy sessions.