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Latest Depression Treatments

The good news is that if your depression doesn't improve after treatment with psychotherapy or antidepressants, the latest fast-acting medications show promise for treating depression that is resistant to treatment for depression and anxiety.

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) is also referred to 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, the ketamine. This has been shown to be effective in cases of severe depression. The nasal spray works with an oral antidepressant to treat depression that has not responded to standard medications. In one study 70% of patients with 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 increases levels of naturally occurring chemicals in the brain, called neurotransmitters. These chemicals transmit messages between brain cells. The results aren't immediate. Patients usually feel better after a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine reduces symptoms of depression by strengthening connections between brain cells. In animal studies, esketamine reversed these connections that are damaged by chronic stress and depression. It also appears to encourage the development of neurons which can help reduce suicidal thoughts and thoughts.

Another reason why esketamine is distinct from other antidepressants is the fact that it is delivered through an nasal spray which allows it to get into the bloodstream faster than pills or oral medication could. It has been demonstrated by studies to decrease depression symptoms within a couple of hours. In some cases, the effects can be immediate.

A recent study that followed patients for 16-weeks found that not all patients who started treatment with esketamine were in Remission. This is not unexpected, according Dr. Amit Anand, an expert on ketamine, who was not involved in the study.

For now, esketamine is only available through a clinical trial or private practice. Esketamine is not a first-line treatment for depression. It is prescribed when SSRIs and SNRIs don't be effective for a patient suffering from treatment-resistant depressive disorder. A patient's physician will determine if the disorder is resistant to treatment and determine if the use of esketamine is beneficial.

2. TMS

TMS uses magnetic fields in order to stimulate brain nerve cells. It is noninvasive and does not require anesthesia or surgery. It has been shown to help patients suffering from depression who haven't responded to medications or psychotherapy. It can also be used to treat obsessive compulsive disorder (OCD) and tinnitus.

TMS therapy for depression is usually given in a set of 36 daily treatments spread out over six weeks. The magnetic pulses may be felt as pinpricks on the scalp. It could take some time to get used to. After the treatment, patients are able to return to work or at home. Based on the type of stimulation used and the stimulation pattern used, each TMS session lasts between 3.5 and 20 minutes.

Researchers believe that rTMS works by altering the way that neurons communicate with one another. This process, also known as neuroplasticity, enables the brain to establish new connections and change its function.

TMS is FDA approved to treat depression in situations that other treatments such as talk therapy and Medication To Treat Anxiety And Depression have failed. It has also proven to be effective in treating tinnitus as well as OCD. And scientists are exploring whether it could be used to treat anxiety and Parkinson's disease.

TMS has been proven to help with depression in several studies, but not everyone who receives it benefits. Before beginning this treatment, it's important to undergo an extensive medical and psychiatric evaluation. TMS is not for you when you have a history of or certain medications.

Talking to your doctor can be beneficial if experiencing depression but aren't seeing any benefits from the treatment you are currently receiving. You may be a suitable candidate to try TMS or other forms of neurostimulation however, you must test several antidepressants first before insurance coverage covers the cost. If you are looking to learn more about these life-changing treatments, contact us today to schedule a consultation. Our specialists will guide you through the process of determining if TMS treatment is right for you.

3. Deep stimulation of the brain

For those suffering from treatment-resistant depression, a non-invasive treatment that rewires the brain's circuits could be effective in less than one week. Researchers have devised new strategies that deliver high-dose electromagnetic waves to the brain quicker and with a schedule that is more manageable for patients.

Stanford neuromodulation therapy (SNT) SNT, which is now offered at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic makes use of MRI imaging to guide electrodes which send magnetic pulses to specific areas of the brain. In a recent study, Mitra and Raichle observed that in three-quarters of patients with depression, the usual flow of neural activity from the anterior cingulate cortex and the anterior insula was reversed. With SNT, that flow returned to normal within a week, which coincided with a lifting of their depression.

Deep brain stimulation (DBS), a more invasive procedure, may produce similar effects in some patients. After several tests to determine the most appropriate place for the implant, neurosurgeons can insert one or more wires, referred to as leads, inside the brain. The leads are connected by the neurostimulator. It is placed beneath the collarbone. It appears like a pacemaker. The device delivers an uninterrupted electric current through the leads. This alters the brain’s natural treatment for anxiety and depression circuitry, reducing depression symptoms.

Certain psychotherapy therapies, such as cognitive behavioral therapy and inter-personal therapy may also relieve depression symptoms. Psychotherapy can be done in a group setting or in one-on-one sessions with a mental healthcare professional. Some therapists also offer telehealth services.

Antidepressants are a key component of treatment for depression. However, in recent times there have been significant advancements in the speed at which these medications 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 treatments, like electroconvulsive treatment (ECT) or repeated transcranial magnet stimulation (rTMS) make use of magnetic or electric stimuli to stimulate the brain. These are more involved procedures that require a doctor's supervision. In some instances, they can cause seizures or other serious adverse side effects.

4. Light therapy

Bright light therapy, which entails working or sitting in front of an artificial light source, has been known for a long time to treat major depression disorder through seasonal patterns (SAD). Studies show that it can relieve symptoms like fatigue and sadness by controlling the circadian rhythms and enhancing mood. It is also a great option for those who experience depression that comes and goes.

Light therapy mimics sunlight, which is a major element of a biological clock known as suprachiasmatic (SCN). The SCN is connected to mood and light therapy has the ability to alter the circadian rhythms that may contribute to depression. Light therapy can also lower melatonin and restore the function of neurotransmitters.

Some doctors employ light therapy to treat winter blues. This is a milder version of depression that is similar to SAD but affects fewer individuals and is more prevalent during the seasons when there is the least amount of daylight. They suggest sitting in front of a light therapy box each morning for 30 minutes while awake to reap the most benefits. In contrast to antidepressants that can take weeks to begin working and can cause adverse effects such as nausea or weight gain, light therapy can produce results within a week. It's also safe during pregnancy and in older adults.

However, some researchers warn that one should not try light therapy without consulting of a psychiatrist or mental health professional, because it could cause a manic episode for bipolar disorder sufferers. Some people may experience fatigue in the first line treatment for depression week because light therapy can alter their sleep-wake pattern.

PCPs should be aware of new treatments that have been approved by the FDA However, they shouldn't be ignoring tried-and-true approaches like antidepressants and cognitive behavioral therapy. "The quest for more effective and innovative treatments is exciting, but we must continue to focus on the most well-established therapies," Dr. Hellerstein tells Healio. He suggests PCPs need to educate their patients on the benefits of new treatments and assist them in sticking to their treatment plans. This could include arranging transportation to the doctor's appointment, or establishing reminders for them to take their medications and attend therapy sessions.