(RxWiki News) Here's a look at some new treatment options for depression currently under investigation.
Some people have depression that is not alleviated by standard therapies. New treatment options are under investigation. Some are now used widely. And they have been found to be as effective as medication for clinical depression. One example is repetitive transcranial magnetic stimulation (rTMS).
- With this technique, an electromagnetic coil is placed on the scalp. It is not surgically implanted.
- A high-intensity current passes through the coil and produces a powerful magnetic field. This affects the function of the underlying brain cells.
- The treatment is remarkably safe and has few side effects, but it is still being refined.
Other approaches being researched also center on brain-stimulating techniques. This includes deep brain stimulation (DBS).
- This involves the implantation of a device that delivers an electrical current to the brain. This normalizes its activity.
- Like the heart, the brain is an electrical organ. Stimulating it with a small electrical current is an efficient way to target areas that are malfunctioning. This is more efficient than drug therapy. Drugs tend to affect the whole brain and often cause side effects.
Results of small trials have been encouraging. But the finer points of the procedure are still being debated. This includes the precise areas of the brain to stimulate, the optimal number of electrodes to implant, and the voltages to use. DBS is not without risk. It is, after all, brain surgery. It carries with it the chance of hemorrhage (excessive bleeding) in the brain, infection, and even death. But it has helped about half the people who have been treated with it. All of these patients had unsuccessfully tried many other approaches.
Besides DBS, studies have shown that vagus nerve stimulation (VNS) may help people with treatment-resistant depression. A vagus nerve stimulator is a small, surgically implanted device. It is designed to stimulate the brain periodically through the vagus nerve. This is a major nerve that passes from the brain through the neck and chest into the abdomen.
Additional drugs are also being tested for treating depression, including:
- Drugs that stimulate the production of gamma aminobutyric acid (GABA). GABA is a neurotransmitter that suppresses the action of nerve cells.
- Medications that block the action of glutamate. This is a neurotransmitter that stimulates nerve cells.
- Drugs that block substance P. This is a protein originally investigated for its role in pain.
- Blockers of corticotropin-releasing factor receptors. These play a role in the body’s reaction to stress.
Even the wrinkle fighter onabotulinumtoxinA (Botox) is under investigation. In one study1, researchers randomly assigned 85 people with depression to receive a single injection of Botox or a placebo between the eyebrows. This was to inactivate the facial muscles used when frowning. The study found that 52% of participants who received Botox responded. This means their depressive symptoms were reduced by about half. This was compared with 21% who received the placebo.
Botox has been approved by the FDA for treating numerous medical conditions. This includes muscle spasms, chronic migraine headaches, overactive bladder, and certain types of eye muscle problems. But it has not been approved to treat depression.
- Eric Finzi. Journal of Psychiatric Research, May, 2014.