Medicines for Depression continued...
All antidepressants carry a boxed warning about increased risks of suicidal thinking and behavior in children, adolescents, and young adults 18-24 years old. Depression and other psychiatric problems are also linked to increased risk of suicide. All patients started on antidepressant medication should be monitored closely.
Other medicines may be prescribed in addition to antidepressants, particularly in treatment-resistant depression. Here are examples of medicines that may be used to augment antidepressant treatment:
- Abilify (aripiprazole)
- Lithium (Lithobid, Eskalith)
- Risperdal (risperidone)
- Seroquel (quetiapine)
- Zyprexa (olanzapine)
Your doctor may recommend or prescribe other medications or supplements for use in depression treatment.
Working with your doctor, you can weigh the risks and benefits of treatment and optimize the use of medication that best relieves your symptoms.
ECT (Electroconvulsive Therapy) for Depression
This is a safe and effective treatment for people with depression that is resistant to medication. It's typically used on people who haven't been helped by medicines or therapy.
In ECT, your doctor will use electric charges to create a controlled seizure. These seizures seem to affect the chemical balance and functioning of the brain. It may sound scary. But during the procedure, you receive anesthesia and a muscle relaxant, so you won't feel anything.
ECT tends to work very quickly. It also works well -- about 70%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.
You might have up to 12 sessions over a few weeks. Some people get "maintenance" therapy with ECT to prevent depression from returning.
Transcranial Magnetic Stimulation for Depression
Transcranial magnetic stimulation is another nondrug approach for depression that is mildly resistant to drug treatment. Unlike VNS and ECT, it uses an electromagnetic device held to the forehead to induce a much smaller electric current in the region of the brain that controls mood -- without causing a seizure or loss of consciousness.
TMS works best in patients who have failed to benefit from one, but not two or more, antidepressant treatments. Also, unlike ECT, TMS does not require sedation and is administered on an outpatient basis. Side effects, if any, are minimal; they might include discomfort at the site where the magnet is placed and mild headache.
Patients undergoing TMS must be treated four or five times a week for four weeks.
Research hasn't shown whether TMS works best alone or in combination with medication. It is considered safe, and in key studies, it's been shown to be effective. A study funded by the National Institute of Mental Health concluded that active TMS treatment for 5-6 weeks seemed to have the most benefit, especially for people whose depression was mildly resistant to drug therapy.