Depression Treatment Options

Last Editorial Review: 3/9/2011

Once you have a depression diagnosis, your doctor will discuss the different depression treatment options with you. The kind of depression treatment that's best for you depends on the type of depression you have. For example, some patients with clinical depression are treated with psychotherapy, and some are prescribed antidepressants. Others are prescribed antidepressants and psychotherapy. Still others may undergo electroconvulsive therapy (ECT), also called electroshock therapy. This treatment may be used with patients who do not respond to standard depression treatment options.

Whatever depression treatment your doctor prescribes, it's important to understand that there are no "instant" solutions. You may have to try different antidepressants to find the most effective drug for you. In addition, you'll have to take the antidepressant for several weeks to see if it benefits you at all. Being patient is important. Trust your doctor to know your personal history. With that, he or she can find the best depression treatment options that help improve your mood.

What Are Depression Drugs?

Depression drugs can help lift your mood and ease the sadness and hopelessness you feel. You'll need to work with your doctor to find the depression medicine that is most effective with the fewest side effects.

How Do Antidepressants Work?

It's thought that three chemical messengers are involved with depression. The three are norepinephrine, serotonin, and dopamine, which are neurotransmitters. Neurotransmitters transmit electrical signals between brain cells.

Researchers have found a link between chemical imbalance in these brain chemicals and depression. Antidepressant medications increase the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers. It is believed that modifying these brain chemicals can help improve mood, although the exact ways they work is still unclear.

What Are the Types of Antidepressants?

There are several types of antidepressants.

These drugs improve symptoms of depression. The major types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs). SSRIs work by altering the amount of a chemical in the brain called serotonin.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs are another form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine.
  • Tricyclic antidepressants (TCAs). TCAs primarily affect the levels of two chemical messengers in the brain, norepinephrine and serotonin. Although these drugs are effective in treating depression, they can have more side effects than other drugs. So they typically aren't the first drugs used.
  • Monoamine oxidase inhibitors (MAOIs). MAOIs are most effective in people with depression who do not respond to other treatments. They are also effective for treating other mental illnesses. Substances in certain foods like cheese, beverages like wine, and medications can interact with an MAOI. So people taking this drug must adhere to strict dietary restrictions. For this reason these antidepressants also aren't usually the first drugs used.

There are other antidepressants that are not members of these classes.

Why Are Stimulants Prescribed for Depression?

Doctors sometimes prescribe other medications such as stimulants and anti-anxiety drugs to use in conjunction with an antidepressant. This is especially likely if the patient has a co-existing mental or physical disorder. However, neither anti-anxiety medications nor stimulants are effective against depression when taken alone.

Talk to your doctor about this type of treatment. Ask if it might boost the effect of your antidepressant.

What Is Psychotherapy's Role in Depression Treatment?

The role of psychotherapy in treating depression is to help the person develop appropriate and workable coping strategies. These strategies help deal with everyday stressors and increase medication adherence. There are different types of psychotherapy, including individual, family, and group therapy. Your doctor will help you find the best type of psychotherapy for you.

When Is Electroconvulsive Therapy (ECT) Recommended for Depression?

Electroconvulsive therapy (ECT), also known as electroshock therapy, is typically used to treat severe depression. During ECT, a skilled doctor applies a brief electric current through the scalp to the brain. This current induces a seizure. ECT is very effective at treating depression.

ECT is generally used when severe depression is unresponsive to other forms of therapy. Or it might be used when patients pose a severe threat to themselves or others and it is dangerous to wait until medications take effect.

For in-depth information, see WebMD's Electroconvulsive Therapy (ECT) for Depression.

What Is Vagus Nerve Stimulation (VNS) for Depression?

Vagus nerve stimulation (VNS) can be used to treat those with treatment-resistant depression, using a pacemaker-like device that is implanted in the body. Once implanted, this device delivers regular electrical impulses to the vagus nerve, one of the nerves that relays information to and from the brain.

What Is the Transcranial Magnetic Stimulation (TMS) Device for Treating Depression?

The FDA has cleared the NeuroStar TMS device for treating depressed adults for whom one antidepressant has failed to work.

While ECT uses an electric current to induce seizure, TMS creates a magnetic field to induce a much smaller electric current in a specific part of the brain without causing seizure or loss of consciousness.

TMS is used to treat milder depression and works best in patients who have failed to benefit from one, but not two or more, antidepressant treatments. Also, unlike ECT, TMS does not require sedation and is administered on an outpatient basis.

Patients undergoing TMS must be treated four or five times a week for four weeks.

WebMD Medical Reference


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American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

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Reviewed by Louise Chang, MD on March 09, 2011

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