Finding the right treatment for depression calls for experts who understand the complexities of depression and have the skill and experience to tailor a treatment plan to your unique situation. And that’s exactly what we do at Bowman Medical Group in Beverly Hills, California.
We approach depression differently. We don’t just prescribe medication and hope your symptoms go away. We get to know you, what happened in your past, what you’ve tried, how your symptoms behave, what’s worked to relieve your depression, and what hasn’t.
Armed with this information, we develop a personalized treatment plan that may include one-on-one or group talk therapy, and it may include medication, as well.
Here, we take a closer look at two effective medications — esketamine and antidepressants — so you can be better informed about your treatment and take control of your health and wellness.
Physical changes in the brain linked to depression
If you have depression, your brain looks different from the brains of those who don’t. Depression causes physical changes in the brain, including a shrinking hippocampus (the part you use to learn and remember things) and prefrontal cortex (used for making plans and solving problems).
A depressed brain is typically inflamed, especially if you’ve had untreated major depressive disorder for many years. Depression may also trigger structural problems in your brain that interfere with its ability to function properly.
Your brain contains billions of neurotransmitters, chemicals that carry messages to and from your brain cells. Abnormalities in certain neurotransmitters, namely serotonin and norepinephrine, are often associated with depression. But that’s only part of the story.
Two more chemical messengers — GABA and glutamate — play a big role in regulating your mood and your capacity for higher thinking. When the connections between your nerve cells become damaged or disconnected, it leads to depression.
The good news is there are effective treatments for depression that can repair these broken connections. Two of the most effective medications are antidepressants and esketamine.
Antidepressants have been around since the 1950s and are a mainstay in treating depression. About 11% of Americans ages 12 and over take antidepressants to manage their depression.
There are four main types of antidepressants:
- MAOI: monoamine oxidase inhibitor
- TCA: tricyclic antidepressant
- SNRI: serotonin norepinephrine reuptake inhibitor
- SSRI: selective serotonin reuptake inhibitor
SSRIs (brand names Celexa, Prozac, Paxil, and Zoloft) are the most frequently prescribed antidepressant. They block absorption (reuptake) of serotonin in your brain to ease the way for your neurotransmitters to do their jobs.
Antidepressants are an essential part of treatment for many people, but they don’t work for everybody. In fact, up to 30% of people with depression get no relief from antidepressants.
Esketamine is a powerful medication that’s made the rounds as an illegal street drug for many years under many names, including Special K. But ketamine is also a legitimate medicine used in hospitals as a general anesthetic that causes deep sedation and reduced sensation of pain.
In lower doses, studies show, ketamine can quickly and dramatically reduce the symptoms of depression.
Ketamine can be administered intravenously to treat depression, but this delivery method isn’t approved by the FDA for this purpose.
At Bowman Medical Group, we offer FDA-approved Spravato®, a version of ketamine that comes in a nasal spray. We often prescribe it in conjunction with an antidepressant for patients with treatment-resistant depression or major depressive disorder with thoughts of suicide.
The difference between Esketamine and antidepressants
Antidepressants and esketamine both alter the chemicals in your brain to relieve your depression, but they target different neurotransmitters. Antidepressants focus on serotonin and dopamine. Esketamine focuses on glutamate.
In some cases, esketamine may work more quickly than antidepressants and have fewer side effects.
More than medication
Antidepressants and Spravato are only two of the many tools we use to treat depression.
Transcranial magnetic stimulation (TMS) is noninvasive, non-drug treatment that uses magnetic pulses to stimulate the tissues in your brain and activate your neurons. Your brain responds by increasing production of serotonin, norepinephrine, and dopamine, which improves your mood.
To learn more about the latest treatments for depression, schedule a consultation at Bowman Medical Group by calling us at 310-982-7003.