Neuroscience is changing treatment for many disorders, including depression. Much of the research is now being done by physical intervention in the brain—deep brain stimulation. Drug discovery programs are getting less attention.
The pharmaceutical industry has pretty much given up on developing drugs that are more selective in their effects on the brain. Now scientists are interested in identifying and modifying the key brain circuits.
Instead of focusing on dysfunctional neurotransmitters, which Prozac and other drugs target, scientists are finding dysfunctions in a network of interconnected brain regions that process rewarding or aversive responses to emotional stimuli.
The brain is a series of networks that support different aspects of our experience and behavior. So understanding how certain brain areas interact differently when someone gets depressed, for example, tells more than measuring brain activity.
Stimulators have been used in more than 100,000 patients, most for Parkinson’s patients. They are also used for treating pain, epilepsy, eating disorders, addiction, controlling aggression, enhancing memory and other behavior problems. Billions of dollars have been committed to research in this area in the next ten years.
How it works: very small electrodes are implanted in both hemispheres of the brain and connected to a neurostimulator, usually under the skin on the right chest. It allows stimulations of different pulse width and frequency, and “neuromodulates,” or alters, the function of the surrounding brain tissue. This is less invasive than former interventions. And it’s reversible. DBS has also been used in cases of OCD (obsessive-compulsive disorder) and depression.
There are very different forms of depression depending on which areas of the cortex, or the areas below the cortex, are affected. DBS is likely to lead to less invasive treatments of the brain for depression.
This blog is based on two articles: Changing Brains: Why Neuroscience Is Ending the Prozac Era by Vaughan Bell, The Observer (U.K.) 9-21-2013, and Scientist Interview: Implanted Electrodes Reboot Brain out of Intractable Depression by Gary Stix, Scientific American 10-3-2013. Stix interviewed Thomas Schlaepfer, an expert in deep brain stimulation.
In my last Psychology Today blog I wrote about anxiety, which is often related to depression. Hopefully DBS treatment will also alleviate anxiety and phobias.
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