What is Treatment Resistant Depression?
Your Guide to Treatment Resistant Depression (TRD) Treatment resistant Depression…
Your Guide to Treatment Resistant Depression (TRD)
Treatment resistant Depression (TRD) refers to depressive symptoms that do not respond well to treatment, making it particularly difficult for individuals suffering from this severe and debilitating form of Depression.
Depression can significantly impact a person’s functioning and overall well-being. However, it can be extremely draining for those unfortunate enough to have TRD. Approximately 50% to 60% of patients do not experience positive results from antidepressant medications, highlighting the seriousness of this health concern.
A Minute in the Clouds With Greg Day 24
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This is the third in the series covering Depression, and today we are talking about Treatment Resistant Depression (TRD). It is what we will be exploring today. Let’s dive in…
Treatment Resistant Depression (TRD)
Treatment resistant Depression (TRD) is when patients don’t respond well to typical antidepressant treatments. It affects many people and requires careful evaluation and consideration of different factors for effective management.
Assessing TRD can be difficult due to varying levels of resistance to treatment. Researchers are working on classifying TRD, but more testing is needed. Medical professionals use rating scales to help determine the severity of TRD. Source: National Library of Medicine
Population Wide Study for TRD
A population-wide study on treatment-resistant depression (TRD) published in December 2022 in the Journal of the American Medical Association (JAMA) found that TRD patients have more mental health issues, use more healthcare services, have higher mortality rates, and longer episodes compared to those without TRD. TRD episodes are also associated with:
- Higher Rates of Anxiety, Stress, Sleep Disorders.
- Substance Use Disorders.
- Intentional Self-Harm Is Over 4 Times More Common.
- Trd Patients Have a 23% Higher Risk of Death.
- Utilize More Healthcare Resources.
- More Missed Workdays.
- Higher Rates of Disability and Worse Outcomes.
- More Doctor Visits.
- Higher Societal Costs for Caring for These Patients.
The study highlights the need for structured and timely depression care.
TRD Treatment Studies
Many studies have been conducted, and ongoing research is being carried out to understand how patients respond to different treatments. These studies also aim to assess the acceptability and tolerability of different augmentation agents for treatment resistant Depression (TRD).
Additionally, they examine recovery rates and rates of drop-out, with a focus on evidence-based approaches for enhancing mental health. Some alternative treatments for treatment resistant Depression (TRD) that have been researched or are ongoing include the following:
Ketamine Therapy
Repeated intravenous doses of Ketamine are safe and effective in treating treatment resistant Depression. Ketamine is thought to work as an antidepressant by modulating the glutamatergic system. Another way to administer ketamine therapy is through a nasal spray, often sold under the brand name SPRAVATO® (esketamine)
Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy (ECT) is recommended by the American Psychiatric Association as a treatment for refractory Depression. It is considered safe and effective for treating psychiatric disorders, including reatment Resistant Depression. Additionally, it may help treat movement disorders that do not respond to other treatments.
Triiodothyronine
Adding triiodothyronine to treatment can help people with treatment resistant Depression. Triiodothyronine is a hormone produced by the thyroid gland that is important for various bodily functions.
rTMS and Treatment Resistant Depression
Researchers are studying the use of high-frequency repetitive transcranial magnetic stimulation (rTMS) as an intensive treatment for depression that doesn’t respond to medication. They are also looking into the effects of maintenance repetitive transcranial magnetic stimulation (rTMS) on treatment-resistant depression.
Quetiapine Augmentation
Researchers are studying the use of quetiapine as an additional treatment alongside antidepressants for major depressive disorder. Quetiapine, also called Seroquel, is a medicine used to treat mental health conditions like schizophrenia and bipolar disorder.
Psilocybin Therapy
Scientists are studying whether psilocybin, a substance found in certain mushrooms, can help treat depression that doesn’t respond to traditional treatments. When combined with psychological support, psilocybin shows promise as a potential treatment option.
Magic Mushrooms
Some street names for psilocybin are magic mushrooms, mushrooms, and shrooms. Psilocybin, a compound with potential antidepressant effects, has been studied in trials as a treatment for Depression.
Previous studies required patients to stop taking antidepressants before receiving psilocybin, but a recent trial examined its efficacy when taken alongside an SSRI and the antidepressant effects of psilocybin in participants with treatment resistant Depression, emphasizing the potential significance of the acute psychedelic experience.
Vagus Nerve Stimulation (VNS)
Vagus Nerve Stimulation (VNS) is a medical procedure extensively studied as a potential treatment for people with treatment resistant Depression. The vagus nerve, which helps regulate mood and emotions, is stimulated with electrical impulses to potentially reduce depression symptoms.
VNS has shown promising results in clinical trials, with some patients experiencing significant improvements. As more research is done, VNS holds promise as a therapy for those who haven’t responded to traditional depression treatments.
Buprenorphine/Samidorphan
Opioid modulation with buprenorphine/samidorphan has been studied as an adjunctive treatment for treatment resistant Depression. Buprenorphine is a medication used to treat opioid use disorder (OUD).
Neurobiological studies provide evidence that opioid receptors are abundantly distributed in cortical areas implicated in the stress response, as well as in subcortical areas involved in regulating emotions.
Scopolamine and TRD
The potential of scopolamine, an extensively studied antimuscarinic drug, as an alternative treatment for individuals with treatment-resistant depression (TRD) has been demonstrated. Scopolamine is commonly employed as a patch to alleviate persistent nausea following surgery.
The Role of Glutamate and Glutamine
Reduced levels of glutamate and glutamine in the prefrontal region and lower levels of GABA have been found to be significantly associated with major Depression and treatment resistant Depression (TRD). These neurochemical imbalances in the brain may play a crucial role in the development and persistence of depressive symptoms.
Researchers hope to develop more targeted and effective treatments for individuals struggling with these debilitating mental health conditions by further understanding the intricate interplay between these neurotransmitters.
Deep Brain Stimulation (DBS)
DBS has also been studied as a treatment for stubborn depression. It involves using electrical stimulation to target a specific area of the brain. This is done by implanting electrodes in the brain and connecting them to a pulse generator in the chest.
Parkinson’s Disease
Currently, Deep Brain Stimulation is utilized to treat Parkinson’s disease, other movement disorders, and medication-refractory obsessive-compulsive disorder. For more information, refer to this article by clicking on the following link: Click Here for NIH Article Link
I hope you enjoyed today’s content. If you are new here, I’m glad you stopped by. It’s not easy creating when you have several health challenges.
What I’m Thankful For Today
Today, I am grateful for the support groups/community I am part of.
I attend a Chronic Pain Support Group, A Mens Traumatic Brain Injury Support Group, and a Traumatic Brain Injury support group. They are all on Zoom on Thursdays. That makes Thursdays a busy day for me.
The Chronic Pain Support Group meets at 1:00 p,
TBI Men’s Group meets at 2:00 pm
Traumatic Brain Injury Support Group meets at 3:00 pm.
What Are You Grateful for Today?
What are you grateful for today? Let me know in the comments any content or topics you would like me to discuss.
As always, thank you for watching. I love you all!
I hope you enjoyed today’s content.
See you tomorrow, and remember:
TAKE CARE OF YOUR MIND!