Reading Between the (Head)Lines

A different take on today's top stories

New Treatments May Deliver Immediate Relief For Depression

Two new treatments appear to provide immediate relief for depression.

Two new treatments for depression have the potential to not only work quickly but also to redefine our thinking as to the cause of depression with respect to brain chemical and electrical activity.

Low Field Magnetic Stimulation (LFMS) is a new procedure which provides immediate and highly significant relief to those suffering from major depression and bipolar depression—at least based in the first clinical trial. The results from researchers at Harvard and Cornell were published in the most recent issue of Biological Psychiatry.

The treatment was discovered by accident when Dr. Michael Rohan and his team conducted an imaging study on healthy participants and found an antidepressant response in the subjects. This, in turned, led to the creation of the first LFMS device, where the brain would be subjected to low strength, high frequency electromagnetic waves.

This is not the same as Transcranial Magnetic Stimulation (TMS), another noninvasive treatment. LFMS is very different. Harvard Medical School Department of Psychiatry's Michael Rohan, PhD, says of LFMS, "It uses magnetic fields that are a fraction of the strength but at higher frequency than the electromagnetic fields used in Transcranial Magnetic Stimulation and electroconvulsive therapy."

As I discussed previously with TMS, 68 percent of patients showed improvement with their depression symptoms, while 45 percent were still in full remission after a year. The big drawback with TMS is the need to treat five days a week, an hour a day over six weeks. Regarding oral medications, antidepressants can take four to six weeks for the full benefits to kick in.

In the LFMS study, the 63 participants who were diagnosed with major depressive disorder or bipolar disorder and already on a regular regimen of meds for a minimum of six weeks were chosen to participate. Roughly half received LFMS, while the other half did not receive any brain stimulation, though they went through a sham process, so neither researchers nor participants knew who had actually received the treatments. After a 20 minute treatment, those who received LFMS experienced an immediate statistically significant improvement in mood, and suffered no side effects.

In addition, there is an exciting new medication for depression that provides almost instant relief as well, and that is the drug Ketamine. Presently, Ketamine is an FDA approved med that is used both to start and maintain general anesthesia, as sedation and as a pain killer. It also can be abused and is used in the club scene as a recreational drug causing disassociation.

Ten patients with who suffered from depression were given Ketamine intravenously up to six times. Nine of 10 patients responded with a decrease in symptoms after the first infusion. Most of these relapsed within three weeks so the long term effects are unclear.

Of course any IV treatment would be difficult to administer in a doctor’s office. But in a study published online in Biological Psychiatry this year, researchers gave patients intranasal ketamine spray and noted an antidepressant effect in 40 percent of patients at 24 hours. Unlike IV treatment, intranasal meds could be administered in an ongoing process.

Ketamine works differently than antidepressants currently on the market (which target norepinephrine, serotonin and dopamine) and blocks the NMDA receptor in the brain. This somehow has the ability to alleviate the symptoms of depression within hours, as opposed to weeks. There are more trials planned for additional research which should began to address many unanswered questions.

The exciting aspect here is the immediate relief that was noted in both treatments. It has long been held that brain chemistry, receptors and neurotransmitter levels took weeks to change via meds, certain psychotherapies or TMS. This gradual change eventually leads to a remission in symptoms. These two quick fixes, if replicated, have the potential to change our view of the underlying cause/effect of depression.

As for LFMS and ketamine obviously more research is needed to see if the studies can be replicated, if multiple treatments will provide greater relief and how long the decrease in symptoms persists. In the meantime, both the treatments are exciting tools with tremendous promise.

Dale Archer, M.D., is a clinical psychiatrist and author of The New York Times bestseller, Better Than Normal: How What Makes You Different Can Make You Exceptional.

more...

Subscribe to Reading Between the (Head)Lines

Current Issue

Just Say It

When and how should we open up to loved ones?