Latest Depression Treatments If your depression doesn't improve through psychotherapy and antidepressants new medications that respond quickly could be able to treat depression resistant to treatment. SSRIs are the most popular and well-known antidepressants. These antidepressants work by altering the way the brain uses serotonin. Cognitive behavioral therapy (CBT) is also referred to as cognitive behavior therapy, assists you in changing negative thoughts and behaviors such as hopelessness. The NHS offers 8 to 16 sessions. 1. Esketamine The FDA approved the new treatment for depression in March 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 works with an oral antidepressant to treat depression that hasn't responded to standard medication. In one study 70% of patients with depression that was resistant to treatment received this medication responded well - a much more rapid response rate than taking an oral antidepressant. Esketamine differs from standard antidepressants. It increases the levels 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 for a longer time than with SSRIs or SNRIs, which can take anywhere from weeks to months to begin to show effects. Researchers believe that esketamine reduces symptoms of depression by strengthening the connections between brain cells. In animal studies, esketamine reversed these connections that are damaged through depression and chronic stress. It also appears to stimulate the development of neurons that help reduce suicidal thoughts and feelings. Esketamine is distinct from other antidepressants in that it is administered via nasal spray. This allows it to enter your bloodstream much faster than pill or oral medication. The drug has been shown to reduce depression symptoms within a matter of hours, and in some individuals the effects are nearly immediate. A recent study that followed patients for 16-weeks found that not all patients who started treatment with esketamine were actually 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 in the study. For now, https://www.iampsychiatry.com/depression-treatment is only available through the clinical trial program or private practice. Esketamine is not a primary option for treating depression. It is prescribed when SSRIs and SNRIs don't be effective for a patient suffering from treatment-resistant depression. The doctor will determine if the disorder is resistant to treatment, and then determine whether esketamine may be beneficial. 2. TMS TMS makes use of magnetic fields to stimulate nerve cells in the brain. It is non-invasive and does not require surgery or anesthesia. It has been shown to help people with depression who have not responded to medication or psychotherapy. It's also been used to treat obsessive-compulsive disorders and tinnitus (ringing in the ear). TMS therapy for depression is usually given in a set of 36 daily treatments spread over six weeks. The magnetic pulses can feel like pinpricks in the scalp. It can take time to get used to. Patients can return to work and home immediately after a treatment session. Each TMS session lasts between 3.5 minutes and 20 minutes, depending on the stimulation pattern. Researchers believe that rTMS can alter the way that neurons communicate. This process, known as neuroplasticity, enables the brain to create new connections and change its function. TMS is FDA approved to treat depression in cases that other treatments such as talk therapy and medication have failed. It has also 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 and anxiety. TMS has been shown to reduce depression in a number studies, however not every person who receives it benefit. Before beginning this treatment, it is essential to undergo an extensive mental and medical evaluation. TMS is not a good option in the event of a history or are taking certain medications. If you have been suffering from depression and are not getting the benefits from your current treatment plan, a conversation with your psychiatrist may be beneficial. You may be eligible for a TMS trial or other forms neurostimulation. However, you need to first try several antidepressants before your insurance company will cover the cost. Contact us today to schedule a consultation to learn more about. Our experts will assist you through the process of the decision of whether TMS treatment is suitable for you. 3. Deep brain stimulation A non-invasive therapy that rewires the brain's circuitry could be effective in just one week for those suffering from depression that is resistant to treatment. Researchers have come up with new methods that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter amount of time and at a frequency that is more adaptable for patients. Stanford neuromodulation therapy (SNT), that is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic utilizes MRI imaging to guide electrodes which send magnetic pulses to the targeted areas in the brain. In a recent research, Mitra & Raichle found that in three quarters of patients suffering from depression that the normal neural activity was disrupted, shifting from the anterior cortex to the anterior isola. SNT returned that flow to normal within a few days, and it was perfectly timed with the lifting of depression. A more in-depth procedure known as deep brain stimulation (DBS) can yield similar results in some patients. Neurosurgeons will perform a series tests to determine the best place to implant one or more leads in the brain. The leads are connected to a neurostimulator that is implanted under the collarbone, which appears like a heart pacemaker. The device delivers an ongoing electric current through the leads. This alters the brain’s natural circuitry, reducing depression symptoms. Certain psychotherapy treatments can help alleviate 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 psychotherapists provide telehealth. Antidepressants remain a cornerstone of treatment for depression. However, in recent years, there have been remarkable advancements in the speed at which these medications can work to 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 therapies use electric or magnetic stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that must be done under the supervision of a doctor. In some instances they may cause seizures or other serious adverse 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). Studies show that bright light therapy can decrease symptoms like fatigue and sadness by improving mood and controlling circadian rhythm patterns. It is also beneficial for those suffering from depression that is intermittent. Light therapy mimics the sun, which is a key element of a biological clock known as suprachiasmatic (SCN). The SCN is associated with mood, and light therapy can rewire misaligned circadian rhythm patterns that can contribute to depression. In addition, light can reduce melatonin levels and improve the functioning of neurotransmitters. Some doctors employ light therapy to combat winter blues. This is a milder type of depression that is similar to SAD, but only is more common and is more prevalent during the months in which there is the least amount of daylight. To get the most effective results, they recommend that you lie in front of the light therapy box for 30 minutes every morning while awake. Contrary to antidepressants, which may take weeks to begin working and can often cause side effects such as weight gain or nausea light therapy can provide results within a week. It is also safe for pregnant women as well as older adults. Researchers warn against using light therapy under the supervision of an expert in mental health or psychiatrist, since it may trigger manic episodes in people with bipolar disorders. It could also make people feel tired in the first week of treatment because 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 dismiss the tried-and-true techniques like antidepressants or cognitive behavioral therapy. "The pursuit of newer and better is exciting, but we must keep focusing on the most effective treatments," Dr. Hellerstein tells Healio. He says PCPs should inform their patients about the advantages 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 patients to take their medications and attend therapy sessions.