Researchers are working on new approaches to treatment-resistant depression. They offer hope to people who haven't been able to control their depression with traditional methods. Currently, some of these approaches are available for people with depression only through research studies.
Here are some of the newest advances for tackling treatment-resistant depression.
When Scott Davis, 38, was suffering from major depression, he confided in his sister-law. “One day I found myself talking to her about all my fears about the depression, and the medication and therapy I was beginning. I was overcome with anxiety about my future, and she said, ‘I’ve been there.’ Those three words lifted all the pain I was feeling.”
Few decisions are as personal as whether to tell a loved one that you are suffering from major depression. “Telling someone about depression isn’t something...
Transcranial Magnetic Stimulation (TMS, or rTMS) sends bursts of energy -- from electromagnets -- to specific areas of the brain. This treatment is thought to affect nerve cell communication in the brain that may play a role in depression.
Although TMS is still rare, the procedure is fairly simple and can be done in a doctor's office. It was approved by the FDA as a standard (nonexperimental) treatment for depression in October, 2008. The TMS device itself has two parts: an insulated wire coil (that can look like a paddle) and a box that supplies the power. During the procedure, the doctor will place the "paddle" against your scalp. The specific area of your scalp depends on what part of the brain your doctor is trying to affect. When switched on, the wire coil creates a magnetic field that can painlessly penetrate your brain. This magnetic field excites the targeted brain areas. Sessions often last about 30 minutes. You might be treated five days a week for two to four weeks.
While more research needs to be done, TMS seems to have few risks and side effects, and it doesn't require hospitalization. Some people feel muscle contractions in the scalp. Rarely, TMS causes headaches or dizziness. But no evidence suggests that it affects the memory, like electroconvulsive therapy (ECT) does. However, TMS is a different treatment than ECT and has not been shown to have comparable efficacy to ECT. TMS could cause a seizure, but experts say that's very unlikely.
Many studies using TMS with treatment-resistant depression have shown favorable results. For instance, one small study published in 2005 in Biological Psychiatry compared TMS with a sham treatment (or placebo). TMS treatment was more than six times as successful in causing remission of symptoms.
Magnetic Seizure Therapy (MST) uses strong magnetic fields to trigger a controlled seizure in the brain. The effects are similar to those of ECT. For reasons that doctors don't entirely understand, these seizures can relieve the symptoms of depression rapidly. MST requires a stay in the hospital. During the procedure, you would need to be under general anesthesia. Doctors hope that because the stimulation can be more accurately targeted than ECT, it may have less of an effect on memory.
Much more research needs to be done on MST. According to a 2005 article in Primary Psychiatry, only 40 people worldwide have ever received this treatment. However, the limited evidence suggests that it can work.
Deep Brain Stimulation uses electric current to relieve the symptoms of depression. It is already used as a treatment for Parkinson's disease. Electrodes are surgically implanted in certain regions of the brain and powered by a battery pack implanted in the chest or abdomen. While there hasn't been much research on this approach in people with treatment-resistant depression, the limited results have been promising. One small study published in 2005 in the journal Neuron looked at six people with depression who had not responded to medications, therapy, or ECT. Six months after deep brain stimulation treatment, four still felt positive effects. Three had complete remission of their depression.
While these new treatments are exciting, some are still experimental. Doctors aren't sure yet how well they work long term or what the effects will be. But if you're interested in trying one, talk to your doctor about signing up for a clinical trial.
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