Advances in Depression Treatment

Depression is a highly prevalent and disabling condition associated with significant morbidity and mortality. Currently available treatments for depression include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, various atypical antidepressants, and electroconvulsive therapy. Although these treatments are effective, a significant number of patients do not respond or achieve sustained remission despite aggressive management. Based on an improved understanding of the neurobiology of depression, several novel pharmacologic and non pharmacologic interventions are being developed. Pharmacologic developments include CRF antagonists, glucocorticoid receptor antagonists, substance P receptor antagonists, NMDA glutamate receptor antagonists, transdermal selegiline, so-called "triple" reuptake inhibitors, and augmentation of typical antidepressant medications with atypical antipsychotics. Non pharmacologic advances have largely involved focal brain stimulation techniques including vagus nerve stimulation, transcranial magnetic stimulation, magnetic seizure therapy, and deep brain stimulation.

Depression is one of the most common psychiatric disorders with a life time prevalence of 10% - 20% in the general population and women being at twice the risk of developing depression compared to men. The high prevalence of depression in the general population has an adverse impact on the community and depression affects the patients well being and their productivity in life. It is reported as the third leading cause of disability as measured by disability adjusted life years (DALYs) and is projected to became the second leading cause in 2020. Over the last 50 years, repeated attempts were made to develop a novel antidepressant, with the intention of maximising the efficacy and minimising the side-effect profile. The research has moved from time to time as in the beginning it was focussed on noradrenaline neurotransmission, later on serotonin neurotransmission.

 

  • Antidepressants
  • Psychotherapy in depression
  • Device based clinical trials
  • Stress management
  • Palliative care in depression
  • Ketamine for depression
  • Acupuncture for depression in women

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