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Latest Depression Treatments The positive side is that if your depression does not improve with psychotherapy and antidepressants, new drugs that are fast-acting show promise for treating depression that is resistant to treatment. SSRIs are the most popular 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 despair. The NHS offers 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 derived the anesthetic, ketamine. It has been proven to be effective in cases of severe depression. The nasal spray is used in conjunction alongside an oral antidepressant to combat depression that has not responded to standard medication. In one study, 70% of people with depression that was resistant to treatment received this medication did well – a greater response rate than using an oral antidepressant. Esketamine is different from conventional antidepressants. It raises levels of naturally occurring chemicals in the brain, called neurotransmitters. These chemicals transmit messages between brain cells. The effects aren't immediate. Patients usually feel better after a couple of days, but the effects last longer than SSRIs and SNRIs. Researchers believe that esketamine reduces symptoms of depression by enhancing the connections between brain cells. In animal studies, esketamine reversed these connections which are weakened through depression and chronic stress. It also appears to stimulate the development of neurons which can reduce suicidal feelings and thoughts. Another reason why esketamine is distinct from other antidepressants is the fact that it is delivered via a nasal spray, which allows it to enter the bloodstream faster than a pill or oral medication can. It has been proven to decrease depression symptoms within a matter of hours. In some individuals the effects are nearly immediately. A recent study that tracked patients for 16 weeks found that not all patients who began treatment with esketamine were actually in the remission phase. This is disappointing, but not surprising, according to Dr. Amit A. Anand an expert in ketamine who was not involved in the study. Esketamine is currently only available through an experimental clinical trial or private practice. It isn't considered a first-line treatment for depression and is typically prescribed when SSRIs or SNRIs haven't worked for a person with treatment-resistant depression. A patient's doctor can determine if the condition is resistant to treatment and determine if it is possible to use esketamine for treatment. 2. TMS TMS uses magnetic fields to stimulate neurons in the brain. It is non-invasive and does not require surgery or anesthesia. It has been shown to help people with depression who haven't responded to medications or psychotherapy. depression treatment strategies can also be used to treat obsessive compulsive disorder (OCD) and tinnitus. For depression, TMS therapy is typically given in a series of 36 daily treatments over six weeks. The magnetic pulses can be felt as pinpricks on the scalp. It may take some time to become used to. Patients can return to their work or home after a treatment. Each TMS session can last between 3.5 minutes and 20 minutes, depending on the stimulation pattern. Researchers believe that rTMS alters the ways that neurons communicate. This process is known as neuroplasticity and allows the brain to form new connections and change how it operates. TMS is FDA approved for treating depression in cases that other treatments such as medication and talk therapy have not worked. It has also been proven to be effective in treating tinnitus and OCD. Researchers are examining whether it can be used to treat Parkinson's disease. TMS has been proven to improve depression in a number studies, however not every person who receives it benefits. It is important that you undergo a thorough psychiatric and medical evaluation before trying this type of treatment. TMS is not suitable for you when you have a history of or are taking certain medications. If you have been struggling with depression and aren't getting the benefits from your current treatment plan, having a discussion with your psychiatrist may be beneficial. You could be a good candidate for a trial of TMS or other forms of neurostimulation however, you must test various antidepressants before insurance coverage can cover the cost. If you're interested in learning more about these life-changing treatments, contact us today for a consultation. Our experts will guide you through the process of determining if TMS treatment is suitable for you. 3. Deep stimulation of the brain A non-invasive treatment that resets the brain circuitry could be efficient in just one week for those suffering from depression that is resistant to treatment. Researchers have devised new strategies that deliver high-dose electromagnetic waves to the brain faster and with a schedule that is that is more manageable for patients. Stanford neuromodulation therapy (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 observed that in three-quarters 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 this flow was restored to normal within a week, and coincided with a reduction in their depression. A more invasive technique called deep brain stimulation (DBS) may produce similar results in certain patients. After a series of tests to determine the best place for the implant, neurosurgeons can insert one or more wires, referred to as leads, in the brain. The leads are connected to a nerve stimulator implanted beneath the collarbone, which appears to be a heart-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 therapies like cognitive behavior therapy and inter-personal therapy can also help with depression symptoms. Psychotherapy can be conducted in an environment of group or one-on-one sessions with an experienced mental healthcare professional. Some therapists also offer telehealth services. Antidepressants are still the cornerstone of treatment for depression. In recent times, however there have been significant improvements in how quickly they can alleviate 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 therapies use electric or magnetic stimulation to stimulate the brain, for example electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). These are more complex procedures that require the supervision of a doctor. In some cases they can cause seizures or other serious side effects. 4. Light therapy Bright light therapy involves sitting or standing in front of an artificially bright light source. This therapy has been used for a number of years to treat seasonal depression as well as major depressive disorder (SAD). Studies show that bright light therapy can decrease symptoms such as sadness and fatigue by improving mood and regulating the circadian rhythms. It is also beneficial for those who suffer with depression that is not a continuous one. Light therapy mimics sunlight, which is an essential element of a biological clock referred to as suprachiasmatic (SCN). The SCN is linked to mood, and light therapy can change the patterns of circadian rhythms that can contribute to depression. Additionally, light therapy can reduce melatonin levels and improve the functioning of neurotransmitters. Some doctors employ light therapy to treat winter blues. This is a milder type of depression that is similar to SAD however it affects fewer individuals and occurs during the seasons when there is the least amount of sunlight. They suggest sitting in the light therapy box each morning for 30 minutes while awake to get the maximum benefits. Light therapy produces results in one week, unlike antidepressants which can take a long time to kick in and may cause negative side effects, such as nausea or weight gain. It is also safe for pregnant women and older adults. Researchers caution against using light therapy under the supervision of a mental health professional or psychiatrist, because it can trigger manic episodes for people with bipolar disorders. It may also make some people feel tired during the first week of treatment due to the fact that it can reset their sleep-wake patterns. PCPs must be aware of new treatments that have been approved by the FDA However, they shouldn't overlook tried-and-true techniques like antidepressants and cognitive behavioral therapy. Dr. Hellerstein told Healio that although the quest for newer and better treatments is exciting, we should prioritize the most established therapies. He suggests that PCPs should focus on educating their patients on the benefits of new treatments and assisting patients adhere to their treatment strategies. This can include arranging for transportation to their doctor's office or setting reminders for them to take medications and attend therapy sessions.