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Latest Depression Treatments

If your depression doesn't improve through psychotherapy and antidepressants, new drugs that act quickly may be able treat depression that is resistant to treatment.

SSRIs are the most popular and well-known antidepressants. They work by altering the way that the brain utilizes 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 through the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved a new treatment for depression in March 2019, a nasal spray called esketamine (brand name Spravato). It is created from the anesthetic drug ketamine which has been proven to be effective in cases of severe of depression. The nasal spray can be used with an oral antidepressant in order to treat depression that hasn't responded to standard medication. In one study, 70 percent of people with depression that was resistant to treatment given the drug responded well -- a far higher response rate than with just an oral antidepressant.

Esketamine is different from standard antidepressants. It increases the amount of neurotransmitters that transmit messages between brain cells. The effects aren't immediate. Patients typically feel better within a few days, but effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine reduces depression symptoms by enhancing brain cell connections. In animal studies, esketamine reversed the breakdown of these connections that could be seen in chronic stress and depression. In addition, it seems to promote the growth of neurons that can help reduce suicidal thoughts and feelings.

Another reason esketamine is different from other antidepressants is that it is delivered via nasal sprays, which allows it to reach the bloodstream more quickly than pills or oral medication can. The drug has been shown to decrease symptoms of depression within a matter of hours. In certain people, the effects are almost immediate.

A recent study that followed patients for 16 weeks found that not all patients who started treatment with esketamine were in the remission phase. This is disappointing but not unexpected, according to Dr. Amit Anand, an expert on ketamine who was not part of the study.

Esketamine is only available in private practice or in clinical trials. Esketamine isn't a first-line option for treating depression. It is prescribed when SSRIs and SNRIs don't help a patient suffering from treatment-resistant depressive disorder. The doctor will determine if the condition is not responding to treatment, and then determine whether esketamine might be beneficial.

2. TMS

TMS utilizes magnetic fields to stimulate nerve cells in the brain. It is noninvasive, does not require surgery or anesthesia and has been proven to reduce depression in those who are not responding to medication or psychotherapy. It is also used to treat the disorder of obsessive compulsiveness and tinnitus (ringing in the ear).

TMS treatment for depression is usually given in a series 36 daily treatments spread out over six weeks. The magnetic pulses feel similar to a series of pinpricks on the scalp, and may require some time to get used to. After an appointment, patients can return to work or go home. Based on the stimulation pattern employed the session TMS session lasts between 3.5 and 20 minutes.

Scientists believe that rTMS changes the way neurons communicate. This process is referred to as neuroplasticity, and it allows the brain to create new connections and change how it operates.

Currently, TMS is FDA-cleared to help with depression when other treatments, including talk therapy and medication, have not worked. It has also been proven be effective in treating tinnitus as well as OCD. Researchers are also investigating the possibility of using it to treat Parkinson's disease and anxiety.

TMS has been shown to help with depression in several studies, however not every person who receives it will benefit. It is important that you undergo a thorough psychiatric and medical evaluation before trying this treatment. If you have any history of seizures or are taking certain medications, TMS might not be suitable for you.

A conversation with your doctor could be beneficial if you're experiencing depression but aren't getting any benefit from your current treatment. You may be eligible for an TMS trial or other forms of neurostimulation. However, you need to first test several antidepressants before your insurance company will cover the cost. If you are interested in knowing more about these life-changing treatments, call us today for a consultation. Our specialists will guide you in the decision of whether TMS treatment is the right one for you.

3. Deep brain stimulation

A noninvasive therapy that resets the brain's circuitry could be efficient in just one week for patients suffering from Treatment refractory depression resistant mild depression treatment. Researchers have developed new techniques that enable them to deliver high-dose magnetic pulses to the brain in a shorter time and on a schedule that is more manageable for patients.

Stanford neuromodulation therapy, which is now available in the Advanced Psychiatric Therapeutics Clinic at the UC Davis Department of Psychiatry and Behavioral Sciences, uses MRI images to guide electrodes to send magnetic impulses to targeted areas of the brain. In a recent research, Mitra & Raichle found in three quarters of depression patients the normal neural activity was disrupted, shifting from the anterior cortex to the anterior cortex. With SNT this flow was restored to normal within a week, and coincided with a lifting of their depression.

deep depression treatment brain stimulation (DBS), an invasive procedure, can cause similar results in some 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 with a neurostimulator, which is implanted beneath the collarbone and looks like an electronic pacemaker. The device provides continuous electric current to the leads, which alters the brain's circuitry and reduces depression symptoms.

Some psychotherapy treatments, such as cognitive behavioral therapy and inter-personal therapy, can also help with mild depression treatments symptoms. Psychotherapy can be conducted in an environment of group or one-on-one sessions with an experienced mental healthcare professional. Some therapists offer telehealth.

Antidepressants are the mainstay of depression treatment. In recent times, however, there have been some notable advancements in the speed at which 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 employ magnetic or electric stimulation to stimulate the brain, for example electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that require a doctor's supervision. In some cases they can cause seizures as well as other serious side effects.

4. Light therapy

Bright light therapy consists of sitting or standing in front of an artificially bright light source. This treatment has been utilized for many years to treat seasonal depression treatment types and major depressive disorder (SAD). Studies show that bright light therapy can help reduce symptoms such as sadness and fatigue by improving mood and controlling the circadian rhythms. It can also help those who suffer from depression that is sporadic.

Light therapy mimics the sun, which is a major component of a biological clock referred to as suprachiasmatic (SCN). The SCN is connected to mood, and light therapy can alter the circadian rhythms which can cause depression. In addition, light can reduce melatonin levels and restore the function of neurotransmitters.

Some doctors are also using light therapy to treat a less severe type of depression called winter blues, which is similar to SAD but affects fewer people and only happens in the months with the least daylight. To achieve the most effective results, they recommend that you sit in front of the box for 30 minutes every morning while you are awake. Light therapy produces results in a week, unlike antidepressants, which can take a long time to kick in and can cause negative side effects, such as nausea or weight increase. It is also safe for pregnant women as well as older adults.

However, some researchers advise that a person should never attempt light therapy without consulting of psychiatrists or a mental health professional, because it could cause a manic episode in people with bipolar disorder. Some people may experience fatigue during the first week, as light therapy can alter their sleep-wake cycle.

PCPs should 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 newer and better treatments is exciting, we should focus on the most proven therapies. He says PCPs should focus on informing their patients about the advantages of new options and helping them adhere to their treatment strategies. This can include providing transportation to the doctor's appointment, or setting reminders to patients to take their medications and attend therapy sessions.