from the get-help-now dept.
Research shows that longstanding depression alters the brain -- treatment may require different approaches depending on not just the severity of the depression but also on its longevity:
Is clinical depression always the same illness, or does it change over time?
New brain imaging research from the Centre for Addiction and Mental Health (CAMH) shows that the brain alters after years of persistent depression, suggesting the need to change how we think about depression as it progresses.
The study, led by senior author Dr. Jeff Meyer of CAMH's Campbell Family Mental Health Research Institute, is published in The Lancet Psychiatry.
The research shows that people with longer periods of untreated depression, lasting more than a decade, had significantly more brain inflammation compared to those who had less than 10 years of untreated depression. In an earlier study, Dr. Meyer's team discovered the first definitive evidence of inflammation in the brain in clinical depression.
This study provides the first biological evidence for large brain changes in long-lasting depression, suggesting that it is a different stage of illness that needs different therapeutics - the same perspective taken for early and later stages of Alzheimer's disease, he says.
"Greater inflammation in the brain is a common response with degenerative brain diseases as they progress, such as with Alzheimer's disease and Parkinson´s disease," says Dr. Meyer, who also holds Canada Research Chair in the Neurochemistry of Major Depression. While depression is not considered a degenerative brain disease, the change in inflammation shows that, for those in whom depression persists, it may be progressive and not a static condition.
More information: Elaine Setiawan et al, Association of translocator protein total distribution volume with duration of untreated major depressive disorder: a cross-sectional study, The Lancet Psychiatry (2018). DOI: 10.1016/S2215-0366(18)30048-8
Ketamine could become an approved treatment for depression in the UK soon:
Ketamine has "shown promise" in the rapid treatment of major depression and suicidal thoughts, a US study says. Ketamine has a reputation as a party drug but is licensed as an anaesthetic. The study found use of the drug via a nasal spray led to "significant" improvements in depressive symptoms in the first 24 hours. The Royal College of Psychiatrists said it was a "significant" study that brought the drug "a step closer to being prescribed on the NHS".
The report by researchers from Janssen Research and Development, a Johnson and Johnson company, and Yale School of Medicine, is the first study into ketamine as a treatment for depression that has been done by a drug company.
[...] The study found those using esketamine had a much greater improvement in depression symptoms at all points over the first four weeks of treatment. However, at 25 days the effects had levelled out. The study's authors suggest it could offer an effective rapid treatment for people severely depressed and at imminent risk of suicide and could help in the initial stages of treatment, as most anti-depressants take four to six weeks to become fully effective.
Also at Medical Daily.
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study (DOI: 10.1176/appi.ajp.2018.17060720) (DX)
Can a Framework Be Established for the Safe Use of Ketamine? (DOI: 10.1176/appi.ajp.2018.18030290) (DX)
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