Which depression treatment is right for you: A look at therapies

Learn about the different types of medications and what they do

FILE - A vendor bags psilocybin mushrooms at a cannabis marketplace on May 24, 2019 in Los Angeles. Lawmakers throughout the United States are weighing proposals to legalize psychedelic mushrooms for people. They say alarming suicide rates and a shortage of traditional mental health practitioners has led them to consider research into alternative treatments for depression and anxiety, including so-called magic mushrooms. (AP Photo/Richard Vogel, File) (Richard Vogel, Copyright 2019 The Associated Press. All rights reserved.)

ORLANDO, Fla. – So you’ve been diagnosed with depression — and now you’re looking for treatments to feel better.

First up, it’s important to find the right provider for you. If you’re going to need prescription medication, you’ll need to get linked up with a physician. Your primary care physician may be able to prescribe medications such as SSRIs or SNRIs or other classes of drugs to ease your depression symptoms, but it may be best to see a psychiatrist, who specializes in prescribing for mental health diagnoses and may be more knowledgeable about those medications. More about that HERE on News 6′s Mental Health page.

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That brings us back to treatments. Please note as you read below, this is not medical advice and is only meant to educate you on options that exist. Please always discuss any option you’re interested in with your physician to determine what will work best for you and your situation.

[RELATED: How to get mental health help in Central Florida]

PRESCRIPTION MEDICATIONS

The most commonly prescribed medications are SSRIs, or selective serotonin reuptake inhibitors. This is the most common class of antidepressant and includes drugs like Lexapro, Prozac, Zoloft, etc.

There’s also a class called SNRIs, or serotonin and norepinephrine reuptake inhibitors, which includes Pristiq and Cymbalta. Buproprion, under brand names Wellbutrin or Aplenzin, is another antidepressant that can sometimes be used as an adjunct along with others to ease symptoms.

Other options can include MAOIs or Monoamine oxidase inhibitors and TCAs or Tricyclic antidepressants. There are even some antipsychotic medications that have been shown to help, like Abilify or Rexulti.

Keep in mind, that as your physician works with you to determine what kind of medication is correct for you, there is no one-size-fits-all treatment. Medications take time to build up in your system, so it can be a long, frustrating process to figure out what will work for you. Some medications work better for some than others, and some people need to take more than one kind in order to manage depression. Many medications may interact with other drugs a patient is taking, so that needs to be taken into consideration as well.

There do exist tools that can help you potentially cut down on some of the trial-and-error associated with figuring out what medicines to try.

A company called GeneSight has a Psychotropic Test which analyzes how your genes may affect outcomes with prescribed medicines. It can help your doctor determine which drugs you’re most likely to be successful on, which you’re most likely to have side effects on, which may require dose adjustments, all based on your genetic makeup.

Some insurance companies do cover this test, and most patients pay $330 or less for the test out-of-pocket.

ALTERNATIVE TREATMENTS

Spravato

Spravato is an esketamine nasal spray that is typically used when other depression treatments, like traditional medications, fail. That’s known as treatment-resistant depression. Usually this is recommended after patients have tried a couple of different drugs and not seen enough improvement in symptoms. Spravato is an NMDA receptor antagonist that works differently by acting on a pathway in the brain that affects the most abundant neurotransmitter, glutamate. What happens is patients administer the nasal spray themselves while in office with the provider present.

There is a risk of feelings of disassociation, dizziness, nausea, vertigo among others, so patients are usually required to stay in-office for observation following the treatment for about two hours and must have someone present to drive them.

To find more information or find a treatment center, click HERE.

Ketamine

Spravato was the first FDA-approved ketamine product treatment for depression. Ketamine itself is commonly known as a club drug, but ketamine is actually a dissociative anesthetic. It can also be used to treat depression in certain functions and doses.

It’s important to note that the following is not FDA-approved for the treatment of mental health conditions, although these treatments are available. IV treatments, shots and lozenges are other forms in which it is available, although it can be quite costly. Many places that offer ketamine in IV form charge upwards of $300-400 per session, and require an average of about six to eight sessions. Shots are generally less expensive, but again, you usually require multiple sessions. The lozenges are now available prescribed by doctors and can even be prescribed by online services like Joyous, Mindbloom and others.

Exact programs, dosages and costs of the lozenges vary by company, but the benefit is you can take these in the safety of your home with virtual health care provider supervision and support. The general idea of ketamine treatment is that it can help disrupt negative feelings and thoughts, and help the brain create new, healthier, more positive patterns and pathways, especially when combined with therapeutic activities like talk therapy or journaling.

Mushrooms

Another psychedelic treatment that’s been gaining traction in the last few years is the use of psilocybin mushrooms. A Johns Hopkins Medicine study shows this treatment has relieved major depressive disorder symptoms in adults for up to one month. When given two small doses, two weeks apart, coupled with psychotherapy, adults reported a decrease in symptoms for up to a year.

The general idea here is that psilocybin can induce perceptual changes, influencing a person’s thoughts and feelings in a positive way. Again, it’s important to note —although this option has potential according to research, it was done in a controlled clinical setting under the guidance of a doctor, so it’s not recommended to try at home without a physician’s guidance.

There are other mushroom varieties that are reported to have positive effects on depression. Lion’s Mane is one of them. This is not a psychoactive mushroom, meaning you will not feel high. Over time, research suggests that Lion’s Mane can help reduce depression symptoms. Lion’s Mane can be purchased in most places you buy vitamins or supplements.

TMS Therapy

TMS Therapy, or transcranial magnetic stimulation, is a non-drug, non-invasive therapy that uses targeted magnetic pulses to stimulate areas of the brain that are underactive in people suffering from depression. This treatment typically is administered in roughly 36 20-minute sessions in-office. This means for most patients, they will have to travel to the office every weekday for about seven weeks for the therapy. Results do vary from person to person and can take a few weeks before results are noticeable. There could be potential common side effects, including skin tingling, mild headaches, lightheadedness — some patients also experience worsening of their anxiety.

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About the Author:

Tara Evans is an executive producer and has been with News 6 since January 2013. She currently spearheads News 6 at Nine and specializes in stories with messages of inspiration, hope and that make a difference for people -- with a few hard-hitting investigations thrown in from time to time.