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How is Depression Treated?
Major depression currently has no known reliable cure, but a combination of medications and psychotherapy is often effective at reducing the severity of symptoms in many patients.
Several different medications may be used to treat and manage the symptoms of major depression. Individual medication plans are dependent on the age of the patient, the patient’s responsiveness to treatments, and the severity of their symptoms.
- Selective serotonin reuptake inhibitors (SSRIs). These drugs work by increasing the levels of serotonin, a neurotransmitter chemical in the brain, and higher levels of serotonin seem to help to elevate mood in many people. Common SSRIs include citalopram, escitalopram, fluoxetine , paroxetine, sertraline, and vilazodone.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs). These drugs work similarly to SSRIs in that they increase serotonin levels, but they also increase the level of norepinephine, another neurotransmitter.
- Other antidepressants. Drugs such as bupropion, mirtazapine, nefazodone, trazodone, and vortioxetine work differently from SSRIs or SNRIs but can be effective at treating depression. Tricylclic antidepressants such as imipramine, nortriptyline, amitriptyline, doxepin, trimipramine, desipramine, and protriptyline tend to have more problematic side effects, so they’re less commonly used to treat depression unless the patient has already shown no improvement from SSRIs.
- Monoamine oxidase inhibitors (MAOIs). Drugs such as tranylcypromine, phenelzine, and isocarboxazid can have potentially serious side effects, so they are typically only used to treat depression when other medications don’t work.
A combination of medication and psychotherapy is often the most effective approach to controlling the effects of depression. The most common therapeutic approach is cognitive-behavioral therapy (CBT), an approach that focuses on helping the patient to identify a pattern of harmful thoughts and to construct strategies and solutions for dealing with them that don’t interfere with functionality.
In some severe cases of depression, when more traditional medications and therapies are ineffective, some providers try alternative therapies, such as:
- Electroconvulsive Therapy. In this therapy, an electric current is passed through the brain, disrupting the function of neurotransmitter chemicals. This therapy is usually used on patients who don’t respond to medication, can’t take medication, or are deemed to be at high risk for suicide.
Transcranial magnetic stimulation (TMS). This therapy transmits intermittent electromagnetic pulses through the brain in an attempt to stimulate nerve function. This therapy, too, is usually used on those who don’t respond to medications.
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