Journal Clinical Psychiatry and Cognitive Psychology

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Case Report - Journal Clinical Psychiatry and Cognitive Psychology (2024) Volume 8, Issue 1

Advancements in Treatment for Major Depressive Disorder: From Medication to Therapy

Holmes Pascal *

Department of Psychology, University of Bath, England, United Kingdom

*Corresponding Author:
Holmes Pascal
Department of Psychology, University of Bath, England, United Kingdom
E-mail: pascalhs@uni.bath.uk

Received: 02-Mar-2024, Manuscript No. AACPCP-24-135126; Editor assigned: 04-Mar-2024, PreQC No. AACPCP-24-135126; Reviewed:16-Mar-2024, QC No. AACPCP-24-135126; Revised:23-Mar-2024, Manuscript No. AACPCP-24-135126 (R); Published:30-Mar-2024, DOI:10.35841/ aatcc -8.1.167

Citation: Pascal H. Advancements in Treatment for Major Depressive Disorder: From Medication to Therapy. J Clin Psychiatry Cog Psychol 2024; 8(1):167

Introduction

Major Depressive Disorder (MDD) is a pervasive mental health condition affecting millions worldwide, characterized by persistent sadness, loss of interest in activities, and various physical and cognitive symptoms. Over the past few decades, significant advancements have been made in the treatment of MDD, spanning medication, therapy, and innovative approaches. This article explores the evolution and current state of these treatments, emphasizing the importance of personalized care [1].

SSRIs, such as fluoxetine (Prozac) and sertraline (Zoloft), have been the cornerstone of MDD treatment since their introduction in the 1980s. They work by increasing serotonin levels in the brain, which helps improve mood and emotional regulation. SSRIs are favored due to their relatively mild side effect profile compared to older antidepressants like tricyclics and monoamine oxidase inhibitors (MAOIs) [2].

SNRIs, including venlafaxine (Effexor) and duloxetine (Cymbalta), target both serotonin and norepinephrine reuptake, providing a broader mechanism of action. They are often prescribed when SSRIs are ineffective, offering an alternative with a similar side effect profile. Medications such as bupropion (Wellbutrin) and mirtazapine (Remeron) do not fit neatly into the SSRI or SNRI categories. Bupropion, for example, affects norepinephrine and dopamine reuptake and is known for its activating effects, making it suitable for patients with fatigue and concentration issues [3,4].

Recent years have seen the introduction of ketamine and its derivative esketamine as rapid-acting antidepressants. Administered via intravenous infusion or nasal spray, these drugs can reduce depressive symptoms within hours. They are particularly beneficial for treatment-resistant depression, offering hope for patients who have not responded to traditional therapies. Advances in pharmacogenetics allow for more personalized medication choices based on genetic profiles. This approach can predict an individual’s response to certain antidepressants, reducing the trial-and-error period often associated with finding the right medication [5,6].

CBT remains one of the most effective psychotherapies for MDD. It focuses on identifying and modifying negative thought patterns and behaviors. Numerous studies have demonstrated its efficacy, particularly when combined with pharmacotherapy. IPT addresses interpersonal issues and their impact on depression. By improving communication skills and resolving conflicts, patients can experience relief from depressive symptoms. IPT is especially effective for individuals whose depression is triggered by relationship issues [7].

MBCT combines traditional cognitive therapy with mindfulness strategies. It teaches patients to be present and observe their thoughts without judgment, helping to prevent the recurrence of depressive episodes. MBCT is particularly effective for individuals with recurrent depression. Originally developed for borderline personality disorder, DBT has shown effectiveness in treating MDD, especially in individuals with high emotional dysregulation. It incorporates mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills [8].

TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It has been approved for patients with treatment-resistant depression and has shown promising results in reducing depressive symptoms with minimal side effects. Although it has been in use for decades, ECT remains one of the most effective treatments for severe depression, particularly when other treatments have failed. Advances in technique and anesthesia have improved its safety and reduced associated stigma [9].

VNS involves the use of a device implanted in the chest to send electrical impulses to the vagus nerve. It is used for treatment-resistant depression and has shown efficacy in reducing symptoms and improving mood. Research into psychedelics such as psilocybin (the active compound in magic mushrooms) and MDMA (ecstasy) has shown potential for treating MDD. These substances, when used in a controlled therapeutic setting, can provide profound insights and emotional breakthroughs that contribute to the alleviation of depressive symptom [10].

Conclusion

The treatment landscape for Major Depressive Disorder has evolved significantly, offering a range of pharmacological, psychotherapeutic, and innovative options. While traditional treatments like SSRIs and CBT remain foundational, advancements in genetics, neuromodulation, and psychedelic therapy are opening new frontiers in personalized care. By embracing a holistic approach that combines these modalities, we can provide more effective and tailored treatments for individuals suffering from MDD, ultimately improving their quality of life.

References

  1. Merrick MT, Ports KA, Ford DC. Unpacking The Impact Of Adverse Childhood Experiences On Adult Mental Health. Child Abuse Negl. 2017;69:10-9.

    2. Indexed at, Google Scholar, Cross Ref

  2. Veijola J, Puukka P, Lehtinen V. Sex Differences In The Association Between Childhood Experiences And Adult Depression. Psychol Med. 1998;28(1):21-7.

    3. Indexed at, Google Scholar

  3. Frampton NM, Poole JC, Dobson KS. The Effects Of Adult Depression On The Recollection Of Adverse Childhood Experiences. Child Abuse Negl. 2018;86:45-54.

    4. Indexed at, Google Scholar, Cross Ref

  4. Liao H, Yan C, Ma Y. Impact Of Adverse Childhood Experiences On Older Adult Poverty: Mediating Role Of Depression. Front Public Health. 2021;9:749640.

    5. Indexed at, Google Scholar, Cross Ref

  5. Dagnino P, Ugarte MJ, Morales F. Risk Factors For Adult Depression: Adverse Childhood Experiences And Personality Functioning. Front Psychol. 2020;11:594698.

    6. Indexed at, Google Scholar , Cross Ref

  6. Chapman DP, Whitfield CL, Felitti VJ. Adverse Childhood Experiences And The Risk Of Depressive Disorders In Adulthood. J Affect Disord. 2004;82(2):217-25.

    7. Indexed at, Google Scholar, Cross Ref

  7. Danese A, Moffitt TE, Harrington H. Adverse Childhood Experiences And Adult Risk Factors For Age-Related Disease: Depression, Inflammation, And Clustering Of Metabolic Risk Markers. Arch Pediatr Adolesc Med. 2009;163(12):1135-43.

    8. Indexed at, Google Scholar, Cross Ref

  8. Bemporad JR, Romano S. Childhood Experience And Adult Depression: A Review Of Studies. Am J Psychoanal. 1993;53(4):301.

    9. Indexed at, Google Scholar, Cross Ref

  9. Bethell C, Jones J, Gombojav N. Positive Childhood Experiences And Adult Mental And Relational Health In A Statewide Sample: Associations Across Adverse Childhood Experiences Levels. JAMA Pediatr. 2019;173(11):e193007-.

    10. Indexed at, Google Scholar, Cross Ref

  10. Ege MA, Messias E, Thapa PB. Adverse Childhood Experiences And Geriatric Depression: Results From The 2010 BRFSS. Am J Geriatr Psychiatry. 2015;23(1):110-4.

    11. Indexed at, Google Scholar, Cross Ref

Get the App