Many people who have depression experience significant relief from their symptoms through standard depression treatment, which combines antidepressant medications and psychotherapy. For some people, though, standard depression treatment isn’t quite enough. Doctors refer to this as treatment-resistant depression (TRD). Many people with TRD experience longer and more severe depressive episodes. Fortunately, alternative treatments can provide effective relief for those with treatment-resistant depression.
How is “Treatment Resistant” Depression Treatable?
Healthcare professionals define treatment-resistant depression as an inadequate response to at least one round of standard treatment. Their definition of “alternative treatment” is looser: an alternative treatment can include anything from acupuncture to exercise. Alternative treatments often focus on lifestyle changes, but may also involve specific therapies.
Ketamine IV therapy
Originally used as an anesthetic drug in the 1960s, ketamine developed an unfortunate reputation as a street drug. Starting in the 1990s, mental healthcare providers began prescribing this powerful medication off-label for people with treatment-resistant depression. Why? Because it works differently from standard depression medications.
Standard depression medications simply boost the brain chemicals known to improve mood, which means they relive the symptoms and do not necessarily address the underlying problem. Ketamine is different in that it repairs communication between specific cells of the brain, known as neurons. Chemical messages travel from one neuron to another across gaps, known as synapses. Depression can develop when there aren’t enough synapses to pass along the chemical messages. Ketamine helps regrow synapses to restore communication.
Ketamine also increases the level of glutamate in the brain. Glutamate is a natural substance that carries chemical messages across synapses to improve communication between neurons. Combined, these effects of ketamine may result in a more rapid improvement than with standard antidepressants. In fact, symptoms may begin to fade within a few hours of ketamine treatment, compared with several weeks for standard antidepressant medications.
SPRAVATO™
While mental health professionals prescribe ketamine off-label, which means the FDA has not approved ketamine for treating depression, there is a derivative of ketamine made especially for treatment-resistant depression (TRD). Approved by the US Food and Drug Administration (FDA) in March of 2019, SPRAVATO™ is a nasal spray that contains the ketamine derivative, esketamine.
Healthcare providers prescribe SPRAVATO™ along with an oral antidepressant to maximize its effectiveness. The patient receives SPRAVATO™ nasal spray treatment in a healthcare facility, under the supervision of a qualified provider. After receiving the medication, the patient must remain in the facility for two hours of observation.
Treatment with SPRAVATO™ typically involves two sessions every week for the first month, one weekly during the second month, and then biweekly or weekly.
Psilocybin
Psychedelics have been used for thousands of years in traditional healing ceremonies, and recent studies are beginning to explore their potential for treating mental illness. Psilocybin, a compound found in certain mushrooms, has shown promise in the treatment of depression. In a study of patients with treatment-resistant depression, psilocybin was found to reduce symptoms of depression and anxiety. The effects of psilocybin can last for months or even years after a single dose. As a result, psilocybin is being studied as a potential treatment for other mental illnesses, such as addiction and post-traumatic stress disorder. While more research is needed to understand the full potential of psilocybin, initial studies suggest that it could be an effective treatment for some mental illnesses.
A few states across the US are currently exploring the possibility of legalizing psilocybin for use alongside traditional psychiatric treatments.
Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation (TMS) is a drug-free, non-invasive and painless treatment for depression. TMS is revolutionary in that it utilizes magnetic fields to stimulate neurons, which effectively relieves symptoms in people with treatment-resistant depression that has not responded to two or more standard antidepressant medications. Research shows TMS effectively relieves depression symptoms in people with TRD. The breakthrough treatment may even help alleviate symptoms completely – some patients experience a full remission and no longer need medication.
TMS treatment involves the placement of a small magnetic coil on the patient’s head. A series of electromagnetic pulses move through the coils to stimulate specific regions of the brain associated with mood regulation. Patients undergo TMS treatment 5 times a week for 4 to 6 weeks; each session takes about 20 to 40 minutes. The therapy is most effective when the patient completes a full course of treatment. TMS may boost the effectiveness of standard antidepressants.
BestMind Can Help
Looking for relief from depression? BestMind Behavioral Health can help. We offer a range of treatments for diagnosed treatment-resistant depression, such as standard antidepressant medication management, telemedicine, SPRAVATO™, and transcranial magnetic stimulation.
You don’t have to put up with depression any longer. Our team of caring, compassionate professionals can help you optimize your mental health by providing treatment customized just for you. For more information on alternative depression treatments, please contact BestMind today at 303-468-8018.
