Future Treatment of Depression

The treatment of depression has been shown historically to be extremely difficult.  Patients suffering from major depressive disorder may seek treatment in the form of therapy, prescription medications, or a combination of both. Often times, prescribed medications do not help to relieve the oppressive symptoms of depression, or they may cease to work over time. Many patients find themselves in an endless cycle of trying different medications or combinations of medications, none of which aiding to alleviate their depression. Research continues to be conducted to further our understanding of the pathology of depression and related disorders.

Rebecca Silton and colleagues recently conducted a study regarding positive affect and its association to prefrontal cortical activity in those with remitted depression. They used electroencephalography to study the brain activity of individuals with remitted depression. Their study found that low positive affect was associated with decreased frontal brain activity. This was consistent with other research that suggested that low positive affect was correlated with high levels of prefrontal alpha, or decreased frontal brain activity. High levels of prefrontal alpha may indicate the increased potential for a future depressive episode. Further research like this will continue to aid in our understanding of mood disorders, and therefore the development of better treatments for depression.

New Jersey psychiatrist Steven Levine first prescribed ketamine as a treatment for depression in 2011 to a patient whose severe depression could not be treated with any commercially available antidepressant. Levine was the first psychiatrist in the United States to offer ketamine in a clinical setting. Since then, Levine has given ketamine to over 600 patients to treat their depression, with a success rate close 85 percent, far above the 45 percent success rate for traditional antidepressants, and there have now been hundreds of research studies done on the treatment of depression with ketamine. Though traditionally used as an anesthetic, to help treat depression ketamine is given intravenously in a series of small doses over the course of a few weeks followed by maintenance doses. The drug can help lift depression in as little as a few hours after the first administration. Traditional depression medications, like selective serotonin reuptake inhibitors (SSRIs), may take two weeks or more to begin functioning. The American Psychological Association is currently making guidelines for the administration of ketamine, and the hope is that coverage from insurance companies will soon follow after the guidelines are created.

The work of Rebecca Silton and Steven Levine emphasizes the importance of continued research on the etiology of depression from a variety of perspectives. A greater understanding of the causes of depression will allow for the development of better treatments for patients in the future.

Olksman, Olga. “Depressed? Your Doctor Might Soon Prescribe Ketamine.” The Guardian. 3  
         Mar. 2016.  Web. 4 May  2016. 

http://www.theguardian.com/lifeandstyle/2016/mar/03/depression-medication-fda-psychadelics-ketamine-psilocybin-johnson-and-johnson-mdma

 Silton, Rebecca et al. “Low Positive Affect is Associated with Reduced Prefrontal Cortical
          Activity in Remitted Depression.” Psychophysiology. Article under review. Web. 4 May
          2016.