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Latest Depression Treatments The good news is that, if your depression does not improve after psychotherapy and antidepressants, new drugs that are fast-acting offer promise in treating depression resistant to treatment. SSRIs, or selective serotonin reuptake inhibitors are the most commonly prescribed and well-known antidepressants. They affect the way the brain uses serotonin. Cognitive behavioral therapy (CBT) helps you change negative thoughts and behaviors like hopelessness. The NHS offers 8 to 16 sessions. 1. Esketamine The FDA approved a new treatment for depression in March 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is made from the anesthetic ketamine that has been proven to help in severe cases of depression. The nasal spray is used in conjunction with an oral antidepressant in order to treat depression that hasn't responded to standard medications. In one study 70% of patients suffering from treatment resistant depression who received this medication were able to respond well, which is a significantly more rapid response rate than taking an oral antidepressant. Esketamine differs from standard antidepressants. It raises the levels of neurotransmitters that transmit messages between brain cells. The results don't come immediately. Patients generally feel better after a couple of days, but the effects last longer than SSRIs and SNRIs. Researchers believe that esketamine helps reduce depression symptoms by enhancing connections between brain cells. In animal studies, esketamine reversed these connections that can be broken down by chronic stress and depression. It also appears to stimulate the growth of neurons that can help reduce suicidal thoughts and thoughts. Another reason esketamine stands out from other antidepressants is the fact that it is delivered via a nasal spray that allows it to get into the bloodstream much faster than pills or oral medication would. The drug has been shown to reduce depression symptoms within hours, and in some individuals, the effects are almost instantaneous. However, the results of a recent study that followed patients over 16 weeks revealed that not all patients who began treatment with esketamine was in remission. This is a bit disappointing, but not unexpected, according to 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. It is not considered a first-line treatment option for depression, and is usually prescribed only when SSRIs or SNRIs have not been effective for a patient suffering from treatment-resistant depression. A patient's doctor will determine if the disorder is resistant to treatment and determine if it is possible to use esketamine for treatment. 2. TMS TMS makes use of magnetic fields to stimulate neurons in the brain. depression treatment methods Iam Psychiatry is non-invasive, doesn't require anesthesia or surgery and has been shown to improve depression in those who do not respond to psychotherapy or medication. It has also been used to treat obsessive-compulsive disorders and tinnitus (ringing in the ear). For depression, TMS therapy is typically given as a series of 36 daily treatments spread over six weeks. The magnetic pulses feel like pinpricks placed on the scalp and could require some time to get used to. Patients can return to their workplace and go home straight following a treatment. Each TMS session can last between 3.5 minutes and 20 minutes, based on the stimulation pattern. Researchers believe that rTMS works by changing the way neurons communicate with each other. This process, referred to as neuroplasticity, allows the brain to establish new connections and alter its functions. TMS is FDA approved for treating depression in cases when other treatments like talk therapy and medication have failed. It has also been proven to 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 shown to improve depression in a number studies, however not all who receives it benefit. Before beginning this treatment, it's important to undergo an exhaustive medical and psychiatric evaluation. If you have an history of seizures or are taking certain medications, TMS might not be suitable for you. If you've been struggling with depression and are not experiencing the benefits of your current treatment plan, having a discussion with your psychiatrist might be helpful. You may be eligible to participate in a TMS trial or other forms neurostimulation. However, you must first test several antidepressants before your insurance will cover the cost. If you're interested in knowing more about these life-changing treatments, contact us today to schedule a consultation. Our specialists can assist you in the process of determining whether TMS is the best choice for you. 3. Deep brain stimulation For those suffering from treatment-resistant depression, a noninvasive therapy that rewires brain circuits can be effective within as little as a week. Researchers have devised new methods that permit 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, now available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences utilizes MRI images to guide electrodes to deliver magnetic pulses to targeted areas of the brain. In a recent study, Mitra & Raichle found in three quarters of patients suffering from depression the normal flow of neural activity was disrupted, shifting from the anterior cortex to the anterior cortex. With SNT the flow of neural activity returned to normal within a week, coinciding with a reduction in their depression. Deep brain stimulation (DBS) is a more invasive procedure, can produce similar effects in some patients. After a series of tests to determine the optimal place for the implant, neurosurgeons can insert one or more wires, referred to as leads, inside the brain. The leads are connected to the neurostimulator. It is inserted beneath the collarbone and looks like an electronic pacemaker. The device supplies continuous electrical current to the leads, which alters the brain's circuitry and helps reduce depression symptoms. Some psychotherapy treatments, such as cognitive behavioral therapy and inter-personal therapy, may also relieve depression symptoms. Psychotherapy can take place in an environment of group or one-on-one sessions with a mental healthcare professional. Some therapists offer online health. Antidepressants are still the primary treatment for depression. However, in recent times, there have been remarkable improvements 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, such as electroconvulsive treatment (ECT) or repetitive transcranial magnetic stimulation (rTMS) utilize electric or magnetic stimuli to stimulate the brain. These are more complex procedures that must be done under a physician's care. In some cases they can trigger seizures or other serious side effects. 4. Light therapy Bright light therapy, which is sitting or working in front of an artificial light source, has been known for many years to treat major depressive disorder with seasonal patterns (SAD). Research has shown that it can ease symptoms such as fatigue and sadness by controlling the circadian rhythms and enhancing mood. It also aids people who experience depression that is intermittently present. Light therapy mimics sunlight, which is a major element of the biological clock known as the suprachiasmatic nucleus (SCN). The SCN is linked to mood, and light therapy can alter the patterns of circadian rhythms that can cause depression. In addition, light can reduce melatonin levels and restore the functioning of neurotransmitters. Some doctors are also using light therapy to treat a less severe kind of depression referred to as winter blues. It's similar to SAD but affects fewer people and only occurs in the months when there is less daylight. For the best results, they suggest that you sit in front of the box for 30 minutes each morning while awake. Contrary to antidepressants, which may take weeks to begin working and often cause side effects like weight gain or nausea, light therapy can produce results within a week. It is also safe for pregnant women and older adults. However, some researchers advise that one should never experiment with light therapy without the advice of psychiatrists or a mental health professional because it could trigger a manic episode in those with bipolar disorder. It could also make people feel tired in the first week of treatment because it could alter their sleep-wake patterns. PCPs must be aware of new treatments that have been approved by the FDA, but they shouldn't neglect tried-and-true methods like antidepressants or cognitive behavioral therapy. “The pursuit of more effective and innovative treatments is exciting, but we should continue to prioritize the best-established treatments,” Dr. Hellerstein says to Healio. He suggests PCPs must educate their patients on the benefits of new treatments as well as aid them in sticking with their treatment plans. This may include providing transportation to the doctor's office, or setting reminders for patients to take their medications and attend therapy sessions.