Latest Depression Treatments If your depression doesn't get better through psychotherapy and antidepressants new medications that work quickly could be able to treat depression resistant to treatment. SSRIs, or selective serotonin reuptake inhibitors are the most frequently prescribed and well-known antidepressants. These work by changing how the brain processes serotonin as a chemical messenger. Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behaviours, such as hopelessness. https://www.iampsychiatry.com/depression-treatment offers 8 to 16 sessions. 1. Esketamine The FDA approved the new treatment for depression in March of 2019 which is a nasal spray dubbed esketamine (brand name Spravato). It is created from the anesthetic drug ketamine that has been proven to aid in the treatment of severe cases of depression. The nasal spray is used in conjunction alongside an oral antidepressant to combat depression that has not responded to standard medications. In one study, 70% of people with depression that was resistant to treatment were given this drug responded well - a much higher response rate than just using an oral antidepressant. Esketamine is different from traditional antidepressants. It raises levels of naturally occurring chemical in the brain, called neurotransmitters. These chemicals transmit messages between brain cells. The effects aren't immediately apparent. Patients usually feel better after a couple of days, but effects last longer than SSRIs and SNRIs. Researchers believe that esketamine reduces symptoms of depression by enhancing brain cell connections. In animal studies, esketamine reversed these connections which are weakened by chronic stress and depression. It also seems to promote the development of neurons which can decrease suicidal feelings and thoughts. Another reason why esketamine is distinct from other antidepressants is the fact that it is delivered via an nasal spray which allows it to reach the bloodstream more quickly than pills or oral medication can. The drug has been found to decrease symptoms of depression within a matter of hours. In some individuals the effects are instantaneous. A recent study that tracked patients for 16-weeks found that not all who began treatment with esketamine were in Remission. This is disappointing, but 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 is not a primary treatment for depression. It is prescribed when SSRIs and SNRIs do not help a patient suffering from treatment-resistant depressive disorder. A patient's physician can determine if their condition is resistant to treatment and determine if the use of esketamine is beneficial. 2. TMS TMS makes use of magnetic fields to stimulate neurons in the brain. It is noninvasive and does not require anesthesia or surgery. It has been shown to help patients suffering from depression who have not been able to respond to medication or psychotherapy. It has also been used to treat the disorder of obsessive compulsiveness and tinnitus (ringing in the ears). For depression, TMS therapy is typically given in a series of 36 daily treatments over six weeks. The magnetic pulses feel like pinpricks placed on the scalp, and may take a bit of getting used to. After an appointment, patients can return to work or go home. Each TMS session lasts between 3.5 minutes and 20 minutes, based on the pattern of stimulation. Researchers believe that rTMS functions by altering the way that neurons communicate with one another. This process is referred to as neuroplasticity, and it allows the brain to create new connections and alter the way it functions. TMS is FDA approved to treat depression in situations where other therapies such as medications and talk therapy have failed. It has also been proven to be effective in treating tinnitus and OCD. Researchers are examining whether it can be used to treat anxiety and Parkinson's disease. TMS has been shown to reduce depression in several studies, however not all who receives it benefits. It is essential to undergo a thorough psychiatric as well as medical examination prior to attempting this treatment. TMS is not a good option when you have a history of or a history of certain medications. If you've been suffering from depression and are not getting the benefits from your current treatment plan, a chat with your psychiatrist may be helpful. You could be eligible to participate in a TMS trial or other forms neurostimulation. However, you need to first test several antidepressants before your insurance company will cover the cost. Contact us today to schedule an appointment to learn more about. Our specialists will assist you in the process of deciding if TMS is the best 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 in just a week. Researchers have come up with new techniques that deliver high-dose magnetic waves to the brain faster and at a time that is more manageable for patients. Stanford neuromodulation therapy (SNT) SNT, which is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic, uses MRI imaging to guide electrodes that send magnetic pulses to the targeted areas of the brain. In a recent study Mitra and Raichle observed that in three-quarters of people suffering from depression, the normal flow of neural activity from the anterior cingulate cortex to the anterior insula was reversed. SNT returned the flow to normal within a couple of days, which coincided perfectly with the end of depression. Deep brain stimulation (DBS) is an invasive procedure, can cause similar effects in some patients. After a series of tests to determine the most appropriate placement, neurosurgeons implant one or more wires, known as leads, inside the brain. The leads are connected to an electrical stimulation device, which is implanted beneath the collarbone. It appears like the appearance of a pacemaker. The device delivers continuous electric current to the leads which alters the brain's circuitry and reduces depression symptoms. Certain psychotherapy treatments can aid in reducing depression symptoms, including cognitive therapy for behavioral disorders and interpersonal therapy. Psychotherapy can be offered in one-on-one sessions with an expert in mental health, or in group settings. Some therapists also offer the option of telehealth services. Antidepressants are the mainstay of treatment for depression. In recent times, however, there have been significant improvements in how quickly 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 therapies, such as electroconvulsive treatment (ECT) or repeated transcranial magnet stimulation (rTMS), use magnetic or electric stimuli to stimulate the brain. These are more complex procedures that require under the supervision of a physician. In certain instances they can trigger seizures or other serious side effects. 4. Light therapy Bright light therapy consists of sitting or standing in front of an artificially bright light source. This therapy has been used for many years to treat seasonal depression and major depressive disorder (SAD). Studies have shown that it can alleviate symptoms like fatigue and sadness by regulating the circadian rhythm and improving mood. It also aids people who suffer from depression that is intermittently present. Light therapy mimics the sun, which is a major component of a biological clock called suprachiasmatic (SCN). The SCN is linked to mood and light therapy has the ability to alter the circadian rhythms that can contribute to depression. In addition, light therapy can reduce melatonin levels and improve the neurotransmitters' function. Some doctors are also using light therapy to treat a less severe kind of depression called winter blues. It is similar to SAD but affects fewer people and is only seen in months with the least daylight. For the best results, they recommend that you lie in front of the light therapy box for 30 minutes each morning while awake. Contrary to antidepressants, which may take weeks to kick in and can cause adverse effects such as nausea or weight gain the light therapy method can deliver results within one week. It is also safe for pregnant women and older adults. However, some research experts warn that one should never attempt light therapy without the advice of psychiatrists or a mental health professional because it could trigger a manic episode in those with bipolar disorder. Some people may experience fatigue during the first week, as light therapy can alter their sleep-wake patterns. PCPs must be aware of new treatments that have been approved by the FDA However, they shouldn't neglect tried-and-true methods like antidepressants and cognitive behavioral therapy. Dr. Hellerstein told Healio that while the search for better and newer treatments is exciting, we should be focusing on the most proven treatments. He says PCPs must inform their patients about the benefits of new treatments and aid them in sticking with their treatment plans. This can include providing transportation to the doctor's office, or setting up reminders for them to take their medications and attend therapy sessions.