New ways could mean clear skies for more clouded minds
The latest edition of the journal Current Psychiatry has detailed a range of new emerging treatments for depression, moving care beyond common antidepressants such as Prozac and Zoloft.
New insights into the physiological causes of depression are leading to improved treatments, with high-tech approaches putting relief on the horizon for many sufferers.
The toolbox for treating depression may soon include new medications, electrical and magnetic stimulation of the brain and long-term cognitive behavioural therapy for stress management.
The traditional treatment in recent decades has been to increase the release or block the degradation of three key neurotransmitters – dopamine, norepinephrine and serotonin – but reports say this approach has succeeded in inducing remission for fewer than half of patients.
New theories of depression are focusing on differences in neuron density in various regions of the brain; on the effect of stress on the birth and death of brain cells; on the alteration of feedback pathways in the brain and on the role of inflammation evoked by the stress response.
The new depression theories “should not be viewed as separate entities because they are highly interconnected,” researchers wrote in the outline of the new reports.
“Integrating them provides for a more expansive understanding of the pathophysiology of depression and biomarkers that are involved,” they said.
The authors identify more than a dozen potential biomarkers for depression, including monoamine regulators; proinflammatory cytokines and other inflammatory mediators; mediators of glutaminergic activity and GABAergic activity; and regulators of neurogenesis.
Depression treatments currently offered or on the horizon include corticotropin-releasing hormone antagonists; dexamethasone; partial adrenalectomy; long-term cognitive behavioral therapy; ketamine and other NMDA antagonists; benzodiazepines; anesthetics; deep brain stimulation; transcranial magnetic stimulation; exogenous brain-derived neurotrophic factor; selective serotonin reuptake inhibitors; tricyclic antidepressants; atypical antidepressants; reduction in inflammation; and anti-inflammatory drugs.
Further advice is based on the notion that it typically takes several months to recover from depression, so current depression treatment programs that average just six weeks; “are not long enough for adequate recovery,” authors are Murali Rao, MD, and Julie M. Alderson, DO said.
More information is available in the full reports, accessible here.