The 2017 National Survey on Drug Use and Health (NSDUH) found about 17.3 million U.S. adults age 18 and over “had at least one major depressive episode” in the previous year. Depression affects about 10 to 15 percent of the population annually.
While many individuals find relief from depression by taking prescribed antidepressants and undergoing psychotherapy, antidepressants do not work for everyone. Experts estimate up to 40 percent of patients do not receive relief from traditional antidepressant therapies.
In cases of treatment-resistant depression, several alternative treatment options, including TMS, ECT, and ketamine, may deliver the desired symptom relief.
Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive outpatient procedure that involves the placement of an insulated coil on the patient’s scalp over the area of the brain thought to control mood regulation. A doctor triggers the coil to deliver painless magnetic pulses into the brain.
Studies have found TMS improves symptoms of depression in up to 60 percent of patients who did not receive sufficient relief from antidepressants.
Side effects of the procedure are usually mild and may include headache, scalp discomfort, twitching of facial muscles, and feeling lightheaded. Symptoms usually resolve soon after the session ends.
Many comprehensive studies have tested TMS and found it to be safe and effective for treatment-resistant depression. The Food and Drug Administration cleared TMS in 2008 to treat depression.
Electroconvulsive therapy (ECT)
Used in cases of treatment-resistant depression since the 1930s, ECT remains an effective treatment for patients who have not found relief from antidepressants. Some studies find 70 to 90 percent of those for whom antidepressants were ineffective achieved symptom relief with ECT.
ECT usually takes place in a hospital with the patient under sedation. During the procedure, the doctor delivers an electrical current to the brain via electrodes, which triggers a small, brief seizure. The convulsive effect reduces symptoms of depression and symptoms of other mood disorders, like mania.
Side effects of ECT may include confusion, nausea, headache, or other muscle aches. Symptoms usually resolve within a few minutes up to a few hours. In rare cases, symptoms may last longer.
Ketamine
Originally approved as an anesthetic, multiple studies find ketamine is also an effective treatment for major depression. Ketamine can improve mood within hours, making it especially valuable in cases of suicidal thoughts or actions.
A doctor administers ketamine via an intravenous infusion, or the patient self-administers ketamine as a nasal spray under the supervision of a health care provider. The nasal spray, Spravato, is a prescription medication approved by the Food and Drug Administration (FDA) in 2019 for the treatment of depression.
Side effects may include dizziness, nausea, lethargy, vomiting, dissociation, and more. The FDA warns ketamine has the potential for abuse and misuse, and patients with a history of substance abuse should not use the drug.
Major depression is a serious disorder, but the right combination of psychotherapy, antidepressants, and alternative approaches can relieve symptoms and increase quality of life. Talk to your doctor today about treatment options.
Turning Point of Tampa has been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or admissions@tpoftampa.com.
