lunes, 23 de enero de 2012

Treatment-Resistant Depression


There are certain people that are diagnosed with depression and start a treatment. However, the symptoms do not improve, it means most of the time that you have treatment resistant depression which means that even though medications along with therapy
helps the patients, for these patients is not enough and may not help at all or the symptoms may show up again. As regular depression, treatment resistant depression also varies from Mild to Severe so it requires trying different types of medications to indentify which one really helps. This also implies visiting a mental health doctor such as a psychiatrist, psychologist or another professional for counseling.

Probably just one medication won´t help, and it might be a long, exhausting process where the antidepressants must be switched, another antidepressant or medicine for a different condition must be combined or added. The most common medicines that are prescribed in addition to the antidepressant are:


In add
ition, the therapies are also different and needs to be searched until the right one for the patient is found:

  • Cognitive behavioral therapy.
  • Interpersonal psychotherapy.
  • Family or marital therapy.
  • Group psychotherapy.
  • Psychodynamic treatment.

The following treatments/ procedures are also used, which involves magnetic stimulation or electric charges:

  • Electroconvulsive Therapy (ECT)
  • Vagus Nerve stimulation (VNS)
  • Transcranial Magnetic Stimulation

Classes of Medications


Even though Depression is a result of different factors the medicine is not necessarely prescribed and/or made based on that. The anti-depressants may have different ingredients. However, their goal is the same which most of the times is to control two chemical messengers (neurotransmitters) in the brain which are norepinephrine and serotonin.

One of the most prescribed medicine in outpatients to treat major depression is Sertraline commonly known as Zoloft due to its efficacy and less pronounced side effects. Sertraline is an antidepressant from the selective serotonin reuptake inhibitor (SSRI) class, which increases the level of neurotransmitters serotonin. This is also used to control anxiety and personality disorders.


Though there is a controversy between SSRI and Placebo, that compares its effect on mild or moderate depression and major depression, concludes that both of them are better than having not treatment at all.

Another very common class of antidepressants is Serotonin and norepinephrine reuptake inhibitors (SNRIs) which also is used for attention deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and also helps relieving menopausal symptoms. Different to the SSRIs, this class acts on both Serotonin and norepinephrine not just in Serotonin. One of the most common medications of this class is Cymbalta (duloxetine) which is very effective in elderly, and studies shows that their cognition, pain and depression have improved significantly.


It is also important to mention that all treatments for depression show more results or improvement in patients when the medicine is taken along with therapy.

What is Depression?


Contradictory to what people think, Depression is not only to be sad or have intense feelings of loneliness or related symptoms. This is a medical illness which is treatable and not to be ashamed of.
Due to the lack of knowledge or clinical significance, the term depression has been used most of the times only to refer to a low mood state. However, this illness is more than that, this is includes a low self esteem, sleeping and eating disorders. Depression also leads people to stop enjoying regular activities or hobbies that where fun and exciting once. All these symptoms not only emotionally and physically affects the person who has been diagnosed with depression, it also affects the family, friends and everything near them. Depression does not result only from one factor, this disease is a result of a mix of many factors such as biology, genetics, age, personal problems, and other risk factors.