Clinical Practice Guidelines for the Management of Depression
Depression is known to cause difficulty in daily functioning, self-esteem, sleep, and emotions. With all the research we’ve done with depression, guidelines are needed to organize this information into comprehensible and universal standards of care, informed by our most up-to-date understanding of diagnosis and treatment. The guideline in question comes from India in 2017 and is a keystone because it was the first to officially recommend the use of neuromodulatory treatments (specifically, electroconvulsive therapy; ECT) in severe cases of depression.
Electroconvulsive Therapy (ECT) in Treatment-Resistant Depression
When all else fails, treatment-resistant depression can be especially debilitating: it is associated with recurring depressive episodes, higher risk of suicide, and a greater amount of hospitalizations. For those who fail ≥ 2 gold-standard antidepressants or otherwise have a need for rapid improvement, electroconvulsive therapy (ECT) may be the solution. ECT (in its modern sense) has been used for more than 90 years, but the persisting stigma and media portrayal related to treatment procedures mean it is rarely used in clinical treatments – even though it could help many recover from even persistent depression. This review article examines myths and facts about ECT, including its current use, safety, and side effects.
Differential symptom cluster responses to repetitive transcranial magnetic stimulation (rTMS) treatment in depression
Everyone experiences depression differently. Few studies have looked at how individual symptoms change across treatment, and how they might be related. Specifically, this study was interested in individuals with treatment-resistant depression and how they respond to new, effective repetitive transcranial magnetic stimulation (rTMS) treatments (or the shortened version, iTBS).
Evaluation of the effects of rTMS on self-reported quality of life and disability in treatment-resistant depression: A THREE-D study
Depression doesn’t just affect mood. It also impacts an individual’s ability to function in daily life. This study explored how the use of rTMS and iTBS as new, safe, non-invasive, and effective treatment(s) for treatment-resistant depression affected individuals’ quality of life and levels of disability.
Cognitive Impairment in Treatment-Resistant Depression
Depression is well-known to negatively impact mood, but relatively few studies have looked at how this disorder may impact cognition, or thinking ability. This is important because better cognitive ability is linked to better functioning in daily life (e.g., work or home responsibilities). This information could inform how we help people with depression. We do not know whether everyone with depression has difficulties with their cognition. We also do not know whether these difficulties span across all cognitive domains, or are specific to just a few (e.g., memory, learning). This study looked to answer these questions and identify what may predict worse cognitive impairment in those with treatment-resistant depression.
Understanding the Common Side Effect of Pain During Repetitive Transcranial Magnetic Stimulation Treatment
The symptoms of depression are bad enough without enduring side effects from the medications used to treat them. Newer treatments without drugs include repetitive transcranial magnetic stimulation (rTMS), a non-invasive procedure where patients receive a series of short magnetic pulses over the scalp to stimulate the nerve cells of the brain. Daily 40-minute treatments using a protocol called high-frequency stimulation (HF) are delivered for 6 weeks, however this can be shortened to daily 3-minute treatments using a protocol called intermittent theta burst stimulation (iTBS).
Predicting Response Trajectories for Suicidal Ideation and Negative Mood among Patients with Depression receiving rTMS
Repetitive Transcranial Magnetic Stimulation (rTMS) therapy has been found to be a non-invasive, safe, and effective way of treating depression – even in individuals who do not respond to usual antidepressant medications. In this study, we were interested in how rTMS changed people’s depressed mood and suicidal thoughts.