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Latest Depression Treatments The positive side is that if your depression does not improve after treatment with psychotherapy or antidepressants, the latest fast-acting medications are promising for treating depression that is resistant to treatment. SSRIs, or selective serotonin reuptake inhibitors are the most commonly prescribed and well-known antidepressants. They work by altering the way the brain uses serotonin. Cognitive behavioral therapy (CBT) helps you to change negative thoughts and behaviours like hopelessness. It's available through the NHS for 8 to 16 sessions. 1. Esketamine The FDA approved the new treatment for depression in March of 2019, a nasal spray called esketamine (brand name Spravato). It is derived the anesthetic, Ketamine. It has been proven to be effective in severe 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 patients with depression that was resistant to treatment were given this drug were able to respond well, which is a significantly greater response rate than using an oral antidepressant. Esketamine is different from conventional antidepressants. It increases levels of naturally occurring chemical in the brain, known as neurotransmitters, that relay messages between brain cells. The effects aren't immediate. Patients typically feel a little better after a couple of days, but the effects last longer than with SSRIs or SNRIs. Those can take weeks or even months to begin to show effects. Researchers believe that esketamine improves depression symptoms by enhancing the connections between brain cells. In animal studies, esketamine reversed the breakdown of these connections that can be found in chronic stress and depression. It also appears to stimulate the development of neurons that aid in reducing suicidal thoughts and feelings. Esketamine is different from other antidepressants because it is delivered via nasal spray. This allows it to reach your bloodstream more quickly than oral or pill medication. The drug has been proven in studies to lessen depression symptoms within a few hours. In some instances the effects may be instantaneous. A recent study that followed patients for 16 weeks found that not all patients who began treatment with esketamine were in Remission. This is a bit disappointing, but not surprising, according to Dr. Amit A. Anand an expert in ketamine who was not part of the study. At present, esketamine is only available through a clinical trial or private practices. Esketamine isn't a first-line option to treat depression. It is prescribed when SSRIs and SNRIs don't help a patient suffering from treatment-resistant depression. Doctors can determine if the disorder is resistant to treatment, and then determine whether esketamine may be beneficial. 2. TMS TMS employs magnetic fields in order to stimulate brain nerve cells. It is non-invasive, doesn't require anesthesia or surgery and has been shown to improve depression in people who do not respond to psychotherapy or medication. It can also be used to treat obsessive compulsive disorder (OCD) and tinnitus. For depression, TMS therapy is typically delivered in a series of 36 daily treatments over six weeks. The magnetic pulses can feel like pinpricks on the scalp. It may take some time to get used to. Patients are able to return to work and home immediately after a treatment. Each TMS session lasts between 3.5 minutes and 20 minutes, based on the pattern of stimulation. Iam Psychiatry believe that rTMS can alter the way that neurons communicate. This process, known as neuroplasticity allows the brain form new connections and to modify its function. TMS is FDA approved to treat depression in situations that other treatments such as medications and talk therapy have not been successful. It has also proven to be effective in treating tinnitus as well as OCD. Researchers are examining whether it could be used to treat anxiety and Parkinson's disease. While a variety of studies have proven that TMS can reduce depression but not everyone who gets the treatment experiences a benefit. It is essential to undergo a thorough psychiatric as well as medical evaluation prior to beginning this treatment. If you have an history of seizures or are taking certain medications, TMS might not be suitable for you. A visit to your doctor can be beneficial if experiencing depression but aren't getting any benefit from the treatment you are currently receiving. You may be a candidate to try TMS or other forms of neurostimulation, but you should try various antidepressants before insurance coverage covers the cost. Contact us today to set up an appointment If you're interested in knowing more about. Our experts will assist you through the process of the decision of whether TMS treatment is right for you. 3. Deep brain stimulation For people with treatment-resistant depression, a non-invasive treatment that rewires brain circuits can be effective within less than one week. Researchers have devised new strategies that deliver high-dose magnetic waves to the brain faster and at a time that is that is more manageable for patients. Stanford neuromodulation therapy (SNT) SNT, that is now available at the UC Davis Department of Psychiatry and Behavioral Sciences' Advanced Psychiatric Therapeutics Clinic makes use of MRI imaging to guide electrodes that send magnetic pulses to the targeted areas of the brain. In a recent study Mitra and Raichle found that in three-quarters of patients suffering from depression, the normal flow of neural activity from the anterior cingulate cortex to the anterior insula was disrupted. SNT returned the flow to normal within a couple of days, and it was perfectly timed with the easing of their depression. A more invasive procedure called 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 by an electrical stimulation device, which is implanted beneath the collarbone and looks like an electronic pacemaker. The device is able to deliver an uninterrupted electric current through the leads. This alters the brain's natural circuitry, which reduces depression symptoms. Certain psychotherapy treatments like cognitive behavior therapy and inter-personal therapy can also help alleviate depression symptoms. Psychotherapy can be delivered in one-on-one sessions with a mental health professional, or in a group setting. Some therapists also provide the option of telehealth services. Antidepressants remain a cornerstone of treatment for depression, but in recent times there have been some remarkable advancements in the speed at which these medications can work to alleviate depression 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 therapies use magnetic or electric stimulation to stimulate the brain, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more involved procedures that need to be performed under a physician's care. In certain instances, they may cause seizures or other serious side effects. 4. Light therapy Bright light therapy involves sitting or standing in front of a bright light source. This therapy has been used for a number of years to treat seasonal depression and major depressive disorder (SAD). Research has shown that it can ease symptoms such as fatigue and sadness by controlling the circadian rhythms and improving mood. It can also help people who suffer from depression that comes and goes. Light therapy mimics sunlight which is an essential component of a biological clock known as suprachiasmatic (SCN). The SCN is associated with mood, and lighttherapy can alter circadian rhythm patterns that can trigger depression. Light therapy can also lower the production of melatonin and improve 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 that have the least amount light. They recommend sitting in front of a light therapy box each morning for 30 minutes while awake to get the maximum benefit. Light therapy can produce results within a week, unlike antidepressants, which can take a long time to kick in and may trigger negative side effects, such as nausea or weight increase. It is also suitable for pregnant women and older adults. However, some researchers warn that one should never attempt light therapy without the guidance of a psychiatrist or mental health professional, as it could cause a manic episode in those with bipolar disorder. It can also make people feel tired during the first week of treatment due to the fact that it could alter their sleep-wake patterns. PCPs should be aware of the latest treatments that have been approved by FDA. However, they shouldn't ignore the tried-and-true techniques like antidepressants or cognitive behavioral therapy. “The quest for newer and better treatments is exciting, but we must continue to focus on the most well-established treatments,” Dr. Hellerstein says to Healio. He says that PCPs should be focusing on teaching their patients on the benefits of new treatments and assisting them stick to their treatment plans. That can include providing them with transportation to their doctor's office or setting reminders for them to take medication and attend therapy sessions.