This is your brain…on a pogo stick. Depression Treatment

Well, we’re going to wrap-up the series on the mood disorders by swirling around treatment options for depression. As with the previous posts in the series, the subject matter is so huge that one could write entire books on each treatment alternative. But we’ll hit the highlights and call it a mission.

As with any life-disrupting emotional/mental issue, depression is said to be best managed by a combination of meds and psychotherapy. But all too many sufferers believe once they start a meds regimen their troubles are over and therapy is a non-issue. Well, research indicates that just isn’t true.

So how ‘bout we first have a look at the meds side of the fence. Typically, the first drugs of choice for the treatment of depression are these antidepressants

  • Selective Serotonin Reuptake Inhibitors (SSRIs): fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox)
  • Selective Serotonin Norepinephrine Reuptake Inhibitors (SSNRIs): duloxetine (Cymbalta), venlafaxine (Effexor), desvelafaxine (Pristiq)
  • Norepinephrine Dopamine Reuptake Inhibitor (NDRIs): bupropion (Wellbutrin, Zyban)

If these medications aren’t doing the job, a psychiatrist may turn to…

  • Tricyclic Antidepressants (TCAs): imipramine (Tofranil), desipramine (Norpramin), amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), nortriptyline (Pamelor)
  • Tetracyclic Antidepressant: mirtazapine (Remeron)

Generally speaking, the meds of last resort are…

  • Monoamine Oxidase Inhibitors (MAOIs): phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), selegiline (Emsam)
  • Atypical Antipsychotics: risperidone (Risperdal), aripiprazole (Abilify)… just watch all the TV commercials…in conjunction with an antidepressant

In terms of psychotherapies, the most commonly used for depression are…

  • Cognitive-Behavioral Therapy (CBT): based in how changing our patterns of thought positively impacts our feelings and behavior
  • Interpersonal Therapy (IPT): grounded in psychodynamic theory, it emphasizes building interpersonal relationship skills

For severe cases of treatment resistant depression, electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS, I suppose) are alternatives.

Well, that wraps-up our series on the mood disorders. We hope you learned something about bipolarity and depression, and will return for reference.

Lots of good stuff to come. Why not check back and see what’s on the buffet?