Novel Drug Therapies Can Help in Addressing Treatment Resistant Depression

Depression has been ranked as one of the most debilitating diseases by WHO (World Health Organization), affecting approximately 264 million people across all age groups. Depression is also considered to be a leading cause of disability that has a drastic effect on social and professional life of an individual. It impairs a person’s ability to think, focus, take responsibility, and maintain social relationship or productivity at the work place. The most harmful impact of depression is that it triggers suicidal thoughts and behavior that contribute towards nearly 800000 deaths per year.

Although depression can be treated with a combination of psychotherapies and medication including antidepressants, reports say that nearly one third of depression patients do not respond to therapies, or medication like anti-depressant. This condition is known as treatment resistant depression.

Treatment resistant depression is considered as a chronic condition that exacerbates functional, emotional and economic condition of an individual. Treatment resistance depression comes with greater health complications and other co-morbid mental health conditions, which in turn compound the treatment cost.

So far, the antidepressants used for treating depression follow the mechanism of changing the brain signals by altering the brain signal molecules known as monoaminergic neurotransmitter. It has been observed that many pharmaceutical companies have refrained from developing new drugs for depression since last few years and have completely withdrawn from experimenting with neuro sciences.

New methods of treatment evolving with research

But things have started to change gradually for the better. Recent scientific advances have developed novel antidepressants that adapt a completely different mechanism.

Human brain is quite adaptive and advanced due to its plasticity. Scientists have used this quality of the human brain to develop rapid acting antidepressants. They have targeted the two neuro receptors known as NDMA and AMPA. Blocking these receptors triggers immediate and rapid glutamate release that can have a sharp antidepressant-like effect on treatment resistance depression.

European medicine and US food and drug administration have also approved an antagonist for NDMA known as Esketamine, which is a psychedelic and anesthetic, and it is chemically related to ketamine.

Many recent studies are targeting the use of steroid, anesthetic and psychedelic for treating debilitating psychiatric disorder. Esketamine is used in very less doses for the treatment and its mechanism is based on blocking all the NDMA receptors, which are primarily responsible for its therapeutic antidepressant effect and some are responsible for side effects. Thus, new drugs developed as NDMA antagonist focuses on reducing the side effects of the NDMA receptors.

In 2019, intravenous Allopregnanolone was approved by the FDA to treat postpartum depression and was considered to be an effective medication for the treatment. Another neuroactive steroid, similar to progesterone and known as Allopregnanolone targets GABA receptor and amplification of GABAergic signals throughout the brain, which in turn, improves the symptoms for anxiety and depression.

A new study on psychedelic such as psilocybin, published in the New England Journal of Medicine, shows a promising result for treatment resistant depression. In this new study, Psilocybin is compared to escitalopram, a widely used antidepressant. The findings regarding use of psilocybin are quite interesting. It showed positive results in addressing treatment resistant depression, giving a spark of hope to scientific advances of using psychedelic drugs to treat chronic psychiatric disorders.

Scientists are now developing antagonists for Orexin 2 receptor, which is responsible for regulation of neuronal limbic circuits known to trigger depression.

In another study, scientists are targeting neuroimmune factors such as developing antagonist for microglia (immune cells in brain) that play a major role in depression and neurodegenerative disorders.

And finally, scientists are finding innovative ways to decrease administration of external source of cannabinoid.

Despite new advances, a huge gap still exists in treating conditions such as extreme schizophrenia, relapses and severe depression. However, research is consistently heading in a positive direction to find effective intervention for treatment resistant depression and other extreme psychiatric disorders.

Is Mental Health Problems haunting you? Find Solution with us

Mental health issues and emotional problems can trouble anyone irrespective of age or gender. There can be a litany of underlying reasons triggering mental health conditions such as childhood trauma, traumatic event in life, financial struggle, toxic relationship or an unknown anxiety or anxiousness.

Mental health issues can take control over one’s life, impairing one’s ability to think, focus, react or even taking responsibility. It can make an individual isolated from family and friends. However, mental health conditions are treatable with timely intervention. So, don’t let mental health problems take over your or your loved one’s life.

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