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Depression Treatment Breakthroughs
Scientists are taking on depression from a variety of angles than ever before. These strategies are designed to help you avoid relapses and find the right drug.
If your depression doesn't respond to antidepressants, psychotherapy may be effective. These include cognitive behavioral therapy as well as psychotherapy with others.
Deep Brain Stimulation
Deep brain stimulation (DBS) is an operation in which electrodes are inserted into the brain to target specific areas that cause diseases and conditions like depression. The electrodes connect to a device that emits pulsing electric pulses to help treat the condition. The DBS device, also known as a neurostimulator, can be used to treat other neurological conditions like epilepsy and Parkinson's disease. The pulses of the DBS device can "jam" circuits that are causing abnormal brain activity in depression while remaining in place other circuits.
Clinical trials of DBS have shown significant improvements in patients suffering from treatment resistant depression (TRD). Despite these positive results TRD recovery is not the same for each patient. Clinicians rely on subjective information from interviews with patients and psychiatric rating scales that can be difficult for them to interpret.
Researchers from the Georgia Institute of Technology and Emory University School of Medicine have developed an algorithm to detect subtle changes in brain activity patterns. This algorithm is able to distinguish between depressive and stable recovery states. The study was published in Nature Human Behaviour, exemplifies the importance of combining neuroscience, medical and computer engineering fields to develop potentially life-changing treatments.
During the DBS procedure, doctors place a small wire-like lead into the brain through a hole in the skull. The lead is fitted with electrodes that transmit electrical signals to the brain. It then connects to an extension wire that extends from the brain, through the neck, behind the ear, all the way to the chest. The lead and the extension are connected to a battery-powered stimulator implanted under the skin of the chest.
The programmable Neurostimulator produces electrical current pulses to control abnormal brain activity within the areas targeted by DBS devices. The team utilized DBS in their study to target a specific brain region called the subcallosal cortex (SCC). The scientists found that when SCC was stimulated, it caused an increase in dopamine levels, which can improve symptoms of depression.
Brain Scanners
A doctor may employ a variety of methods and tools to diagnose depression, but the best one available today is brain scans. This technique employs imaging to observe changes at structural and function levels of brain activity. It is able to pinpoint the regions of a patient's brain that are affected by the disorder and to determine what is happening in those regions in real time.
Brain mapping can help to predict the type of treatment will be most effective for a particular individual. Certain people respond better to antidepressant medication than others. However, this isn't always the situation. Psychologists and physicians can prescribe medications more accurately if they use MRI to determine the effectiveness. It can also help increase compliance by allowing patients to see how their treatment is progressing.
The difficulty of measuring mental health has hampered research despite the widespread prevalence. Although there is a wealth of information on depression and anxiety, as well as other disorders, a clear understanding of the causes behind these conditions has been difficult to come by. However, advances in technology are beginning to uncover the mechanisms that cause these disorders.
For example, a recent study published in Nature Medicine sorts depression into six distinct biological subtypes. This opens the way to individualized treatment.
Researchers employed fMRI technology to study the brain activity of 801 people who suffer from depression, and 137 others without. They looked at the activity and connectivity of brain circuits affected by depression, such as those that control cognition and emotions. They looked at the brain scan of a person in a state of rest and while completing specific tasks.
A combination of resting-state measures and task-based ones was able to predict if someone would respond or not to SSRIs. This is the first time that a predictive test has been created in psychiatry. The team is currently working on an automated test that will give these predictive results.
This is especially beneficial for those who aren't responding to the usual type of treatment such as medication and therapy. In fact, as high as 60% of people suffering from depression do not respond to the first form of treatment they receive. Certain patients may be difficult to manage using the standard treatment regimen.
Brain Implants
Sarah was suffering from a severe form of depression that was debilitating. She described it as a black hole that dragged her down. It was a force so strong that she could not move. She tried a range of drugs but none gave her an enduring boost. She also tried other treatments such as ketamine injections and electroconvulsive treatment, but these also failed. Then, she decided to undergo a surgery that would permit researchers to implant electrodes into her brain to give her a targeted jolt whenever she was about to have a depressive episode.
Deep brain stimulation is a procedure that is used extensively to treat Parkinson's disease. It has also been proven to be beneficial for patients who are not able to receive treatment. It's not an effective treatment, but it assists the brain to cope. It utilizes a device that can implant small electrodes into specific brain regions such as the pacemaker.
In the study published in Nature Medicine on Monday, two researchers at the University of California at San Francisco explain how they utilized the DBS to create a custom depression treatment for a particular patient. They called it an "revolutionary" approach that could pave the way for a more flexible DBS therapies for other patients.
The team studied Sarah's brain's circuits, and discovered that her amygdala may be the main cause of her depression episodes. latest depression treatments discovered that the ventral region, an area of her brain is responsible for calming her amygdala's reaction. They then implanted the matchbox-sized device in Sarah's head, and then strung its spaghetti like electrode legs to these two regions.
If a sign of depression occurs the device instructs Sarah's brain to send a small electrical charge to the amygdala as well as to the ventral striatum. This is intended to reduce depression and help her to be more positive. It is not a cure for depression but it makes a big difference for the people who need it most. In the future, this may be used to detect biological markers that indicate depression is on the horizon giving doctors the chance to prepare by increasing stimulation.
Personalized Medicine
Personalized medicine is a method to customizing diagnosis, prevention and treatment strategies to individual patients based on the information obtained through molecular profiling, medical imaging, lifestyle information, etc. This differs from traditional treatments, which are designed to fit an average patient.
Recent studies have revealed a variety of factors which cause depression in various patients. These include genetic variation and neural circuitry dysfunctions as well as biomarkers, psychosocial markers and other. Personalized psychiatry seeks to integrate these findings in the clinical decision-making for optimal treatment. It is also meant to aid in the development and implementation of individualized treatment for psychiatric conditions like depression.
The field of individualized psychiatry continues to grow but there are a few obstacles currently preventing its clinical application. For example many psychiatrists aren't familiar with the various antidepressants and their profile of pharmacology, which can result in a suboptimal prescription. In addition the cost and complexity of the integration of multiomics data into healthcare systems and ethical considerations have to be considered.
A promising way to improve the concept of personalized psychiatry is pharmacogenetics. It aims at utilizing a patient's unique genetic makeup to determine the proper dosage of medication. It has been suggested that this may aid in reducing the adverse effects associated with drugs and improve the effectiveness of treatment, particularly for SSRIs.
However, it is important to point out that this is only an idea and will require more research before it is widely adopted. In addition, other aspects such as environmental influences and lifestyle choices are crucial to consider. The integration of pharmacogenetics into depression treatment must therefore be carefully balanced.
Functional neuroimaging is yet another promising method for guiding the selection of antidepressants and psychotherapy. Studies have proven that levels of pretreatment activation in specific neural circuits (e.g. The response to pharmacological or psychotherapeutic treatment is determined by the ventral and pregenual anterior cortex. Furthermore, some clinical trials have already utilized these findings to guide their selection of participants, focusing on those who have greater levels of activation and thus having more favorable responses to treatment.
Website: https://www.iampsychiatry.com/depression-treatment
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