Depression affects more than 18 million Americans and is the leading cause of disability worldwide. It can seriously disrupt a person’s home, work and social life, and even lead to suicide, the most common cause of death for people between the ages of 10 and 24. Where can those who suffer from this condition turn when traditional treatments such as medication and talk therapy fail?
Two treatments – Transcranial Magnetic Stimulation (TMS) and Ketamine – offer the possibility of relief for people dealing with depression.
TMS, cleared by the Food and Drug Administration (FDA) in 2008 to treat depression that had not improved after taking at least one other medication, can be performed in an outpatient setting with few side effects or time off from work or other activities. The treatment consists of magnetic pulses that are delivered to specific areas of the brain.
“The magnetic pulses help stimulate electrical activity between neurons and activate brain structures, leading to an antidepressant effect,” says Dr. Erin Amato, adult, child and adolescent psychiatrist with the Montana Psychiatry & Brain Health Center. “Unlike medications that have effects throughout the body, thus causing unwanted side effects like weight gain, sexual dysfunction and nausea, TMS is focused on a small area of the brain.”
She points out that headaches are the most common side effect but adds that within a week, this problem usually goes away. She says patients are able to drive themselves to and from treatments and usually can schedule appointments before or after work or during their lunch break.
According to Dr. Amato, most major insurance companies cover TMS treatments. She also says advancements in non-invasive brain stimulation to treat conditions such as OCD, bipolar depression, PTSD and Alzheimer’s are coming soon, and that TMS might also be used to help people stop smoking.
Ketamine, used since the 1960s as a surgical anesthetic for people as well as animals, has become more popular as an antidepressant in the past decade. Unlike conventional medications that can take weeks to start working, ketamine can help right away. To treat depression, it’s administered through an IV infusion or an injection, with doses based on a patient’s weight. Because it is administered in small amounts, ketamine does not put patients to sleep.
“Most people feel relaxed and may experience some sensory distortions, such as seeing colors, feeling a distortion of time or having sounds seem louder or farther away,” Dr. Amato says.
She points out that ketamine has been shown to help alleviate suicidal thoughts, a common symptom of severe depression. This is especially important in Montana, which has consistently ranked among the top five states in suicide rates during the past four decades.
Ketamine is not currently covered by insurance.
“Many people find that the cost of ketamine is offset by the ability to be more productive at work, enjoy their daily activities and relationships and, in some cases, prevent the need for hospitalization when depression is life-threatening,” Dr. Amato says.
To learn more about innovative ways to treat depression, call Montana Psychiatry & Brain Health Center at 406-413-9342 or visit MTPsychiatry.com.
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