Treatment for depression has made significant advancements within the past several years, with exciting new treatment options readily available. While the traditional treatments are still relevant and helpful, newer treatment options give patients additional choices and multiple options if one treatment method doesn’t work.
Newer options include stimulating the brain directly with a medical device (TMS), short-term infusions (ketamine therapy) and even a nasal spray treatment for depression (Spravato).
Each method has its pros and cons, with some treatments more suitable for certain types of depression or co-occurring conditions such as depression and anxiety. This post describes the innovative therapies we offer at NeuPath Mind Wellness to understand how they work and how they differ from one another.
More importantly, if you are struggling with depression, we hope you’ll find the information you need to decide which treatment might suit your needs the best.
The Standard Depression Treatment: Psychiatric Medication Management
For many years now, the first step in treating depression is to prescribe psychiatric medication. Medications like SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) work by balancing key neurotransmitters in your brain, such as serotonin, norepinephrine, and dopamine.
Antidepressants are typically covered by insurance and can be prescribed by a doctor.
The benefits of psychiatric medication management include:
- Convenience: Daily oral medication is a simple, non-invasive treatment you can take at home.
- Low to Moderate Cost: When covered by insurance, cost for monthly medication is typically affordable for most individuals
- Multiple Options: For each class of medication there are several different options available. This can help with finding the right medication that produces the best effect with the fewest side effects. The downside is that this trial and error process can often be frustrating and time-consuming for the patient.
When is it recommended? Medication management is often the first-line treatment for depression, especially for moderate to severe cases. Insurance coverage for more advanced treatments, such as TMS or Spravato, is often contingent on the patient having tried medication first.
Our Delray Beach psychiatry team at NeuPath Mind Wellness will work with you to find the right medication and dosage that helps alleviate your symptoms. We carefully monitor the effectiveness while watching out for any onerous side effects.
What if antidepressants don’t work? For a surprisingly large number of people, antidepressants don’t work – or at least don’t work well enough to achieve full relief. Fortunately, there are other options. At NeuPath Mind Wellness in Delray Beach, we provide advanced depression treatments that can achieve a better outcome than antidepressants, and may even allow you to “deprescribe” from your antidepressant.
Ketamine Infusion Therapy: A Fast-Acting Option
Ketamine has been used successfully for years to treat depression and is often the next step for those who have not responded to other treatments. Ketamine acts on the brain’s glutamate system, quickly forming new neural connections that can lead to a powerful and rapid antidepressant response. Ketamine is the fastest acting depression treatment available on the market today.
The advantages of ketamine infusion therapy include:
- Fast and Powerful Effects: Many patients report feeling a significant improvement within hours or days of the first treatment – much faster than with antidepressants.
- Multi-Condition Treatment: Ketamine infusions are used to several mental health conditions, including treatment-resistant depression, severe anxiety, PTSD, and certain chronic pain conditions.
- Flexible Dosing: Dosing can be carefully adjusted to meet individual needs, allowing for a personalized treatment plan.
When is it recommended? Ketamine infusion therapy is often a good choice for patients with severe, treatment-resistant depression, anxiety, PTSD or suicidal ideation. While it is highly effective, ketamine infusions are not yet FDA-approved for depression and may not be covered by insurance (see Spravato information below). However, the rapid-acting relief from ketamine often makes it a worthwhile investment for patients.
Spravato® (Esketamine) Therapy: Rapid Relief from Major Depression
Spravato® is a derivative of ketamine and delivers many of the same benefits. It is also rapid acting and works by acting on the brain’s glutamate system. Key differences between Spravato and ketamine infusions are that Spravato is delivered as a nasal spray, it is FDA-approved for the treatment of major depressive disorder, and it is typically covered under insurance. Spravato is administered in our Delray Beach ketamine clinic under the supervision of a medical professional. (It is not approved for home dispensing).
The benefits of Spravato include:
- Rapid Action: Like ketamine infusions, Spravato works on a different neurotransmitter pathway (glutamate) than traditional medications, which is why it can deliver much faster results. Patients using Spravato report a significant reduction in depressive symptoms in as little as 24 hours.
- FDA-Approved: Spravato has passed clinical trials and received clearance from the FDA for treatment of major depressive disorder.
- Covered by Insurance: For patients with treatment-resistant depression, Spravato therapy is often covered by insurance, making treatment more affordable.
When is it recommended? Spravato is approved for adults with treatment-resistant depression and for major depressive disorder with suicidal ideation. It is a powerful treatment option for those who meet criteria and have failed to respond to multiple antidepressant trials. Spravato is administered by trained staff to ensure accurate dosing and to monitor for dizziness or other side effects following treatment.
Transcranial Magnetic Stimulation (TMS): Depression Relief Without Medication
TMS is unique in that it is not medication. Instead, TMS targets brain activity directly using non-invasive magnetic pulses that stimulate nerve cells in a specific area of the brain associated with mood regulation. TMS is FDA-approved for the treatment of depression, anxious depression, OCD, and smoking cessation. Clinical trials are ongoing to receive FDA clearance to use TMS for treating other brain disorders.
The advantages of TMS include:
- Highly Targeted and Effective: Using a TMS device, magnetic pulses are precisely targeted to the mood-regulating area of the brain. This produces an effective antidepressant response without affecting the rest of your body, as can happen with medication.
- Non-Invasive and Well-Tolerated: TMS is completely non-invasive. There is no medication involved at all. You simply sit comfortably in a chair while a small magnetic coil is placed against your scalp. This coil sends magnetic pulses to the targeted area of the brain. As your brain adapts over time, TMS requires multiple sessions, with each session lasting less than half an hour.
- Minimal Downtime: There is no downtime with TMS treatment – you can drive yourself to and from appointments and resume your daily activities immediately after each session. There is no brain fogginess to be concerned about. In fact, the opposite is true – patients often report they can think more clearly following a TMS session.
- Insurance Coverage: As an FDA-approved treatment, TMS is often covered by most major insurance providers as long as patients meet treatment criteria.
When is it recommended? TMS is an excellent option for individuals who have not found adequate relief from medication or who cannot tolerate the side effects of antidepressants, such as weight gain or sexual dysfunction. TMS is often a preferred choice for patients who simply do not want to take medication. While TMS does take longer to achieve its result (patients typically notice improvement after three to four weeks), it is often a long-lasting improvement that continues long after treatment has finished.
Find a Psychiatrist in Delray Beach
Choosing the right depression treatment is a deeply personal decision that should be made in partnership with a compassionate and knowledgeable healthcare team. At NeuPath Mind Wellness in Delray Beach, we are here to help you make the right choice of treatment for depression, anxiety, PTSD, or other condition.
Our care team will work together with you to create a care plan that reflects your needs and goals. Our satisfaction comes from helping each patient find the right treatment for them and achieve relief from depression.
If you are looking for a psychiatrist in Delray Beach, contact NeuPath Mind Wellness today at 561-847-3662 or use our online appointment request form to schedule a consultation.
