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Latest Depression Treatments

The good news is that if your depression does not improve after psychotherapy and antidepressants, the latest fast-acting medications offer promise in treating depression that is resistant to treatment.

SSRIs are the most effective treatment for depression popular and well-known antidepressants. They affect the way that the brain utilizes serotonin.

Cognitive behavioral therapy (CBT) assists you in changing negative thoughts and behaviors, such as hopelessness. It is available on the NHS for 8 to 16 sessions.

1. Esketamine

The FDA approved the new treatment for depression in March 2019 nasal spray known as esketamine (brand name Spravato). It is created from the anesthetic drug ketamine for treatment resistant depression which has been proven to aid in the treatment of severe cases of depression. The nasal spray is used in conjunction with an oral antidepressant to treat depression that hasn't responded to standard medications. In one study 70 percent of patients suffering from treatment-resistant depression given the drug responded well with a much higher response rate than with the use of an oral antidepressant.

Esketamine is different from conventional antidepressants. It raises the levels of neurotransmitters that transmit messages between brain cells. The effects aren't immediately apparent. Patients generally feel better within a few days, but the effects last longer than SSRIs and SNRIs.

Researchers believe that esketamine improves depression symptoms by strengthening connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections which can be found during depression and stress. It also seems to promote the development of neurons, which can decrease suicidal feelings and thoughts.

Esketamine is different from other antidepressants due to the fact that it is delivered by nasal spray. This allows it to get into your bloodstream faster than oral or pill medication. The drug has been shown to decrease symptoms of depression within hours, and in some individuals the effects are immediate.

However the results of a recent study that followed patients for 16 weeks revealed that not all patients who began treatment with esketamine remained in the remission phase. This is disappointing but not surprising, according to Dr. Amit Anand, an expert on ketamine but not involved in the study.

Esketamine is only available in private practice or clinical trials. Esketamine is not a first-line treatment for depression. It is prescribed when SSRIs and SNRIs fail to help a patient suffering from treatment-resistant depressive disorder. A patient's physician will determine if the disorder is not responding to treatment and determine if the use of esketamine is beneficial.

2. TMS

TMS employs magnetic fields in order to stimulate brain nerve cells. It what is the best treatment for anxiety and depression noninvasive, doesn't require surgery or anesthesia and has been shown to improve depression in those who don't respond to psychotherapy or medication. It is also used to treat obsessive-compulsive disorder (OCD) and tinnitus.

For depression, TMS therapy 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. Patients can return to work and home immediately after a treatment session. Each TMS session can last between 3.5 minutes and 20 minutes, based on the stimulation pattern.

Researchers believe that rTMS works by changing the way neurons communicate with each other. This process, known as neuroplasticity allows the brain establish new connections and alter its functions.

TMS is FDA approved for Treating Depression Without Antidepressants depression in cases that other treatments such as talk therapy and medication have not worked. It has also been shown to aid those suffering from tinnitus, OCD and pain. Scientists are currently examining whether it could be used to treat Parkinson's disease.

TMS has been shown to improve depression in numerous studies, but not everyone who receives it benefit. Before you embark on this treatment, it is important to undergo an exhaustive medical and psychiatric evaluation. TMS is not for you if you have a history or are taking certain medications.

A conversation with your doctor may be beneficial if you are experiencing depression but aren't experiencing any positive results from the treatment you are currently receiving. You may be a suitable candidate to try TMS or other forms of neurostimulation, but you need to try several antidepressants before insurance coverage covers the cost. If you are interested in learning more about these life-changing treatments, call us today for a consultation. Our experts will guide you in the decision of whether TMS treatment is right for you.

3. Deep brain stimulation

A non-invasive therapy that rewires the brain's circuitry may be effective in as little as one week for patients suffering from treatment resistant depression. Researchers have developed new techniques that enable them to deliver high-dose electromagnetic pulses to the brain in a shorter period of time and on a schedule that is more adaptable 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 direct electrodes to deliver magnetic pulses to specific brain regions. In a recent study, Mitra and Raichle observed that in three-quarters (75%) of patients who suffer from depression, the typical flow of neural activity from the anterior cingulate cortex to the anterior insula was reversed. With SNT, that flow returned to normal within a week, which coincided with a lifting of their depression.

A more in-depth procedure known as deep brain stimulation (DBS) can produce similar results in some patients. After an array of tests to determine the best placement, neurosurgeons implant one or more wires, called leads, into the brain. The leads are connected to a nerve stimulator implanted under the collarbone, which looks like a heart pacemaker. The device delivers continuous electrical current to the leads, which alters the brain's natural circuitry and helps reduce depression symptoms.

Some psychotherapy treatments like cognitive behavior therapy and inter-personal therapy, can also help with depression symptoms. Psychotherapy can be done in groups or in one-on-one sessions with an experienced mental healthcare professional. Some therapy providers offer the option of telehealth.

Antidepressants are the mainstay of depression treatment. In recent times, however, there have been significant improvements in how quickly they can relieve 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 treatments, such as electroconvulsive treatment (ect treatment for depression and anxiety) or repetitive transcranial magnetic stimulation (rTMS) make use of magnetic or electric stimuli to stimulate the brain. These are more involved procedures that require the supervision of a doctor. In certain instances, they may cause seizures as well as other serious adverse effects.

4. Light therapy

Bright light therapy consists of sitting or standing in front of a bright light source. This treatment has been used for many years to treat seasonal depression and major depressive disorder (SAD). Studies show that bright light therapy can help reduce symptoms such as sadness and fatigue by improving mood and regulating circadian rhythm patterns. It is also beneficial for those suffering from depression that is intermittent.

Light therapy mimics sunlight, which is a major component of the biological clock called the suprachiasmatic nucleus (SCN). The SCN is connected to mood, and light therapy can rewire misaligned circadian rhythm patterns that can contribute to depression. Light therapy can also lower Melatonin levels and help restore the function of neurotransmitters.

Some doctors utilize light therapy to combat winter blues. This is a milder version of depression that is similar to SAD, but only is more common and is more prevalent during the times of year when there is the least amount of daylight. To achieve the best natural treatment for anxiety and depression results, they suggest you lie in the light therapy box for 30 minutes each morning while awake. Light therapy results are seen in the space of a week, unlike antidepressants that can take a long time to kick in and can cause negative side effects, such as nausea or weight increase. It's also safe to use during pregnancy and for older adults.

However, some research experts warn that one should not experiment with light therapy without the guidance of a psychiatrist or mental health professional, because it could cause a manic episode for those with bipolar disorder. Some people may experience fatigue during the first week, as light therapy can reset 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 such as antidepressants and cognitive behavioral therapy. "The search for newer and better is exciting, but we should continue to focus on the most well-established treatments," Dr. Hellerstein informs Healio. He says PCPs must educate their patients about the benefits of new treatments as well as aid them in sticking with their treatment plans. This can include providing transportation to the doctor's office or setting reminders for them to take their medication and attend therapy sessions.