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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 show promise for treating depression that is resistant to treatment. SSRIs, or selective serotonin reuptake inhibitors, are the most commonly prescribed and well-known antidepressants. They affect the way that the brain processes serotonin. Cognitive behavioral therapy (CBT), also known as cognitive behavioral therapy assists you in changing negative thoughts and behaviors such as despair. It's available on the NHS for 8 to 16 sessions. 1. Esketamine The FDA approved a new treatment for depression in March of 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is made from the anesthetic ketamine, which has been shown to be effective in cases of severe of depression. The nasal spray is used in conjunction with an oral antidepressant in cases of depression that isn't responding to standard medication. In one study, 70% of people with depression that was resistant to treatment received this medication were able to respond well, which is a significantly greater response rate than taking an oral antidepressant. Esketamine is different from traditional antidepressants. It raises levels of naturally occurring chemical in the brain, referred to as neurotransmitters, that relay messages between brain cells. The results don't come immediately. Patients typically feel a little better after a few days but the effects last for a longer time than with SSRIs or SNRIs, which may take weeks or even months to begin to show effects. Researchers believe that esketamine helps alleviate depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed these connections which are weakened due to depression and stress. It also appears to boost 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 nasal sprays, which allows it to enter the bloodstream faster than pills or oral medication would. The drug has been shown by studies to reduce depression symptoms within a matter of hours. In some instances, the effects can be immediate. However the results of a recent study that followed patients over 16 weeks showed that not everyone who started treatment with esketamine remained in the remission phase. This is disappointing, but it's not surprising according to Dr. Amit A. Anand an expert in ketamine who was not involved with the study. Esketamine is currently only available in private practice or clinical trials. clinical depression treatments isn't considered a first-line treatment for depression and is typically prescribed when SSRIs or SNRIs haven't worked for a person with treatment-resistant depression. Doctors can determine if the condition is not responding to treatment and then discuss whether esketamine might be beneficial. 2. TMS TMS utilizes magnetic fields to stimulate brain nerve cells. It is non-invasive and does not require surgery or anesthesia. It has been shown to aid people suffering from depression who have not responded to medication or psychotherapy. It can also be used to treat obsessive compulsive disorder (OCD) and tinnitus. TMS therapy for depression is typically delivered in a series of 36 daily treatments spread over six weeks. The magnetic pulses are similar to pinpricks placed on the scalp and could be a little difficult to get used to. After the treatment, patients are able to return to work or go home. Each TMS session can last between 3.5 minutes and 20 minutes, depending on the stimulation pattern. Researchers believe that rTMS works by altering the way neurons communicate with one another. This process, known as neuroplasticity, allows the brain to form new connections and to modify its function. TMS is FDA approved to treat depression in situations that other treatments such as medications and talk therapy have not been successful. It has also been proven to help people with tinnitus, OCD and pain. Scientists are also exploring the possibility of using it to treat Parkinson's disease as well as anxiety. TMS has been shown to reduce depression in several studies, but not everyone who receives it benefits. Before you embark on this treatment, it is important to undergo an exhaustive medical and psychiatric examination. TMS is not suitable for you if you have a history or are taking certain medications. A visit to your doctor could be beneficial if you are experiencing depression but aren't experiencing any positive results from your current treatment. You could be a good candidate to try TMS or other forms of neurostimulation, however, you must test several antidepressants first before insurance coverage will cover the cost. Contact us today to schedule an appointment If you're interested in knowing more. Our specialists will guide you through the process of deciding whether TMS is the best option for you. 3. Deep stimulation of the brain For people suffering from depression that is resistant to treatment, a non-invasive treatment that rewires brain circuits can be effective in as little as one week. Researchers have developed new techniques that permit them to deliver high-dose magnetic impulses to the brain in a shorter time and on a schedule that is more suitable 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 send magnetic pulses into specific brain regions. In a recent research, Mitra & Raichle found that in three quarters (or more) of patients with depression that the normal flow of neural activity was disrupted, shifting from the anterior cortex to the anterior cortex. With SNT, that flow returned to normal within a week, coinciding with a reduction in their depression. A more in-depth procedure known as deep brain stimulation (DBS) may produce similar results in certain patients. Neurosurgeons will perform a series tests to determine the ideal placement before implanting one or more leads in the brain. The leads are connected to a nerve stimulator 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 circuitry, reducing depression symptoms. Some psychotherapy treatments may also aid in reducing depression symptoms, such as cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can be conducted in a group setting or in one-onone sessions with a mental healthcare professional. Some therapists also offer telehealth services. Antidepressants remain the primarystay of depression treatment. In recent times, however there have been significant improvements in the speed at which they can alleviate 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 treatments employ magnetic or electric stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complicated procedures that must be done under a physician's care. In some cases, they can 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 treatment has been utilized for many years to treat seasonal depression as well as major depressive disorder (SAD). Research has shown that bright light therapy can decrease symptoms such as sadness and fatigue by boosting mood and regulating the circadian rhythms. It is also a great option for those who suffer from depression, which occurs and disappears. Light therapy mimics sunlight which is a key component of a biological clock called suprachiasmatic (SCN). The SCN is connected to mood and light therapy may alter the circadian rhythms that may contribute to depression. Light therapy can also lower Melatonin levels and help restore the function of neurotransmitters. Some doctors use light therapy to combat winter blues. This is a milder type of depression that is similar to SAD however it has fewer people affected and is more prevalent during the times of year in which there is the least amount light. To get the most effective results, they recommend that you sit in the light therapy box for 30 minutes every morning while you are awake. Unlike antidepressants, which can take weeks to work and often cause side effects like nausea or weight gain the light therapy method can deliver results in a matter of one week. It is also suitable for pregnant women and older adults. Researchers advise against using light therapy without the supervision of a mental health professional or psychiatrist, as it may trigger manic episodes for people with bipolar disorders. It could also make people feel tired during the first week of treatment because it can alter their sleep and wake patterns. PCPs must be aware of new treatments that have been approved by the FDA, but they shouldn't overlook tried-and-true techniques like antidepressants and cognitive behavioral therapy. “The search for more effective and innovative treatments is exciting, but we should keep focusing on the most effective treatments,” Dr. Hellerstein tells Healio. He suggests that PCPs should be focusing on educating their patients about the advantages of the latest treatments and help them adhere to their treatment strategies. This could include arranging transportation to the doctor's office, or setting up reminders for patients to take their medications and attend therapy sessions.