Depression - On the horizon

Research continues to find effective ways to treat depression and to help those living with depression manage their symptoms. Here we look at some of the treatments for depression that are on the horizon.

In this section we look at:

Developments in antidepressant medication

What is it?

A new type of anti-depressant medication called Triple reuptake inhibitors (TRIs).

How does it work?

TRIs affect levels of brain chemicals that affect our mood, specifically norepinephrine, serotonin and dopamineA type of neurotransmitter - chemicals that help the communication between nerve cells (neurons). , and they also target the part of the brain involved in cognition and reward. Decreased activity in this part of the brain has been found in people with depression and it is likely to be responsible for the lack of motivation, interest and pleasure experienced by people with depression. Increasing dopamineA type of neurotransmitter - chemicals that help the communication between nerve cells (neurons). levels by blocking its reuptake might be expected to improve these symptoms.

Who is it for?

People who are living with depression who do not want to take or cannot take selective serotonin reuptake inhibitor (SSRI) anti depressant medication.

What stage of development is it at?

There are two types of TRIs being assessed, one at phase 1 and the other at phase 2. While initial results are encouraging, they are both at relatively early stage of development and further studies are needed to assess their effectiveness.[1]

Acupuncture to help relieve symptoms of depression in pregnancy

What is it?

A new US study is researching the use of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. specifically for depression. Findings suggest that this approach may reduce symptoms during pregnancy as an alternative to medication.

How does it work?

Acupuncture is the ancient Chinese art of healing by inserting very fine needles into the body at specific points and stimulating the needles to regulate the body's self-healing processes. Previous studies involving a wider target group have also shown that acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. can be helpful in relieving the symptoms of depression.

Who is it for?

This treatment is for pregnant women who are experiencing symptoms of depression that do not want to use anti-depressant medication during pregnancy.

What stage of development is it at?

The phase 1 trial study was small but the positive findings warrant further research into this area. The researchers report that this trial is the first of its kind and aim to use the results at this stage to help raise awareness about depression in pregnancy and educate patients and doctors when considering an alternative to medical treatment in pregnancy.[2]

Assessing individual susceptibility to depression

What is it?

A new study is researching why some people are more susceptible to anxiety and depression and less responsive to antidepressants by looking at the molecular characteristics of the brain.

How does it work?

Although it is still unclear exactly which brain mechanisms are associated with depression and anxiety recent research suggests that the combination of a number of stressful life events and biological factors that predispose a person to depression can play a significant role in depressive disorders. Previous studies in humans suggest that regulating serotonin receptors in the brain may be linked with depression and with an individual's ability to respond to antidepressants. Serotonin-1A (5-HT1A) receptors are found in the serotonin neurons (autoreceptors). It is now thought that a geneticRelating to the genes, the basic units of genetic material. alteration in humans that regulates 5-HT1A autoreceptor levels is linked with susceptibility to depression and a decreased response to drug treatment.

Who is it for?

People who experience recurrent depression and are not responding effectively to antidepressant medication.

What stage of development has it reached?

The study suggests that there is a link between 5-HT1A autoreceptor levels, resilience under stressRelating to injury or concern., and the consequent response of an individual to antidepressants. More research is now needed to help develop treatment options aimed at increasing the serotonin levels before beginning SSRI drugs particularly for individuals with higher autoreceptor levels. [3]

S-Adenosyl-L-Methionine (SAMe) for Treatment of Depression

What is it?

SAMe stands for S-adenosyl-L-methionine. SAMe is a compound that is produced by the liverA large abdominal organ that has many important roles including the production of bile and clotting factors, detoxification, and the metabolism of proteins, carbohydrates and fats. and used throughout the body in a chemical process called methylation. Methylation is a process essential to many of the chemical reactions in the body including producing the mood regulating brain chemicals serotonin, dopamineA type of neurotransmitter - chemicals that help the communication between nerve cells (neurons). and norepinephrine.

How does it work?

People with depression often have low levels of dopamineA type of neurotransmitter - chemicals that help the communication between nerve cells (neurons). , serotonin and norepinephrine. Administration of SAMe slows the amount of time if takes to breakdown these brain chemicals therefore allowing them to work longer. Simultaneously, SAMe increases the production of the receptors that receive these neurotransmitters. Having more receptors allows the neurotransmitters that are already present to work more effectively. There is also some research to suggest that SAMe may increase the responsiveness of existing receptors. The combination of these functions increases the levels of neurotransmitters, which in turn decreases depressive symptoms.

Who is it for?

Current research suggests that SAMe can work well for people with mild depressive symptoms, who have no indication of suicidal behaviour, rather than for those with more severe major depression. SAMe may also be of benefit for people who are unable to take standard antidepressant medications due to their side effects.

What stage of development has it reached?

So far, when looking at the potential benefits of using SAMe to treat depression, the results are encouraging. However, studies to date have been small, so it is difficult to determine which groups of people will benefit most from this supplement. Further trials for SAMe are currently recruiting in the U.S. [4,5]

References

  1. M. Breuer, J. Chan, R. Oosting et al European Neuropsychopharmacology, Volume 18, Issue 12, Pages 908-916.
  2. Acupuncture for Depression During Pregnancy: A Randomized Controlled Trial."
    Manber, Rachel; Schnyer, Rosa N.; Lyell, Deirdre; Chambers, Andrea S.; Caughey, Aaron B.; Druzin, Maurice; Carlyle, Erin; Celio, Christine; Gress, Jenna L.; Huang, Mary I.; Kalista, Tasha; Martin-Okada, Robin; Allen, John J. B.
    Obstetrics & Gynecology, March 2010 - Volume 115 - Issue 3 - pp 511-52.
    Source: Stanford School of Medicine.
  3. Neuron, Volume 65, Issue 1, 40-52, 14 January 2010  |  5-HT1A Autoreceptor Levels Determine Vulnerability to Stress and Response to Antidepressants, Jones, Craige et al.
  4. S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease. Summary, Evidence Report/Technology Assessment: Number 64. AHRQ Publication No. 02-E033, August 2009. Agency for Healthcare Research and Quality, Rockville, MD.
  5. Clinicaltrials.gov