Advanced
prenatal depression treatment Treatment
If your depression doesn't respond to a first-line antidepressant, your doctor might suggest increasing the dosage or adding another type of medication. They might also suggest psychotherapy.
The latest psychotherapy techniques, such as augmented depression therapy have empirical support and can help improve depression symptoms. These treatments concentrate on identifying and solving the ways in which depression can affect your daily routine.
Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive brain stimulation that uses magnetic pulses to stimulate neurons that are responsible for mood. It is typically prescribed to treat depression when medications fail or are not appropriate for the individual. It is also used to treat PTSD and is sometimes combined with psychotherapy. TMS is a safe and effective treatment that doesn't cause serious side effects.
During the session, a healthcare professional will place an electromagnetic coil on your scalp to the region of the brain that controls your mood. In the case of rTMS this is the dorsolateral prefrontal cortex (dLPFC). This is a small region that is located in front of your brain. You will hear a clicking sound and feel a tapping sensation as the device delivers pulses to your brain. The healthcare professional will adjust settings to stimulate the desired areas of the brain.
The healthcare professional will determine the intensity of the pulses by determining the amount of energy needed to trigger the thumb to twitch. This is important as it allows them to determine the amount of power they are employing and ensures the safety of the patient. In the past, pulses were given at 120% of motor threshold. But, current research is focused on accelerating TMS therapy to reduce duration of treatment and increase the rate of response.
In a controlled trial that was randomized researchers have demonstrated that TMS can help people with major depressive disorder (MDD) who do not respond to antidepressants. The study showed that those treated with rTMS showed significant improvements in symptoms like low mood sadness, depression, changes in appetite, and decreased enjoyment or interest in activities. The study also showed improvements that lasted for a long time.
Contrary to other forms of brain stimulation such as vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy. It is also safe for women who are pregnant, and it has a low risk of seizures. However, some individuals may feel pain or discomfort on the scalp underneath the magnet during treatment.
The majority of TMS treatments last around half an hour. The provider will inform you what the duration of the treatment will be and may also stop the pulses during this time to let the magnet cool down.
Vagus Nerve Stimulation (VNS)
VNS (also known as Vagus Nerve Stimulation Therapy) is a treatment option that transmits precise electrical signals to alter brain wave patterns and reduce depression symptoms. It's an implanted surgical device that employs a tiny pulse generator that connects to a wire which is placed under the skin and wrapped around the left vagus nerve of the neck. The procedure is FDA-approved for people suffering from depression that is treatment-resistant who have not found relief from other treatments, such as psychotherapy or medication. It's also approved to control seizures in certain epileptic patients.
In the largest study of VNS researchers compared the effectiveness with an sham device for patients who had
shock treatment for depression-resistant monopolar or depressed-phase bipolar disorder. Patients in the VNS group received a moderate, low or high dose of electrical stimulation during a 22-week "acute phase." The primary endpoint was the changes in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS group had significantly better results than those in the group of sham. At a 12-month follow-up participants in the VNS group had a mean IDS-SR30 score of 9.3 points, while those in the group with a sham score scored 4.2 points.
The VNS therapy was well-tolerated, with the most common adverse effects being voice changes or hoarseness and an impression of weight on the chest. Other reported side effects included tingling, headache fatigue, fatigue and changes in speech or swallowing. Some of these happened more often in the higher dose groups, while others occurred at all doses. The frequency of AEs was comparable to those observed in other studies, and generally eliminated by the end of the acute study period.
Psychiatrists at Ohio State Wexner Medical Center regularly take part in national discussions about the
best treatment for depression way to treat depression;
wifidb.science, ways to treat depression and other mood disorders. Our experts are helping define national standards for health care. We are also a part of an international clinical trial, called RECOVER, which is being conducted by the Centers for Medicare & Medicaid Services. The aim of this study is to examine VNS for treating resistant depression. This is a crucial research project, as the evidence available suggests that VNS can offer improving benefit and hope for this difficult to treat chronic population.
Electroconvulsive Therapy (ECT)
ECT is an effective treatment for advanced depression for people who don't get better with medication. It is particularly beneficial for those who are suicidal, or are unable to wait until their medication to take effect.
During the ECT procedure doctors transmit tiny electrical currents through the brain to intentionally cause an instant seizure. The result is that the brain changes chemistry, and improve symptoms of a variety of mental health problems. ECT has been around since the 1930s. Despite the stigma attached to the treatment it has helped a lot of people.
To be given ECT, your psychiatrist will have to conduct a thorough psychiatric assessment. Then they will examine your medical history and conduct several tests which include an electrocardiogram (EKG) as well as blood tests, and perhaps an X-ray of your chest. They will ask you to describe how you think about ECT and will consider any opinions of family members, friends, or advocates representing you.
The ECT procedure is carried out while you sleep under general anesthesia, so you won't feel any pain during the procedure. A mouth guard protects your teeth, and a mask covers your face to allow oxygen. An anesthesiologist injects an the anesthetic via a needle into your vein. Once you've fallen asleep, electrodes are placed on both sides of your head (depending on whether you suffer from bilateral or unilateral ECT). These deliver small electrical pulses to the brain which cause an instant seizure. It lasts between 20 and 60 seconds, and you awaken soon after it's over.
It is important to remember that you are able to revoke your consent for ECT at anytime, even before the first treatment. This is your right under Care Quality Commission (CQC) regulations and your doctor must always consider your wishes when considering ECT for you.
ECT is a great treatment option for people who tried other treatments but failed to notice any improvement. It can also help those suffering from
mild depression treatment depression, severe psychosis or when you're a risk to yourself or others and you are unable to wait for the effects of medication to begin. The majority of people require several ECT sessions over a period of three to six weeks.
Light therapy
Light therapy is a way to compensate for the lack of sunlight, which can contribute to major depression disorder with seasonal patterns (formerly known as seasonal affective disorder). It can be used as a standalone treatment or in conjunction with other treatments like psychotherapy and medication.