Drug-Free Depression Treatment

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If you are like me, and have your TV on late at night, you can recognize the bleary music that each of the antidepressant medications use for their commercials.  There are so many choices, because the choice of an antidepressant is very different than the selection of an antibiotic or antiviral.  A whole decision tree is required to find the proper drug and dose. Moreover, the choice of antidepressant seems to have a similar affect as antibiotics- long term use breeds familiarity—i.e., the drug no longer provides beneficiary results.

And, that does not include the fact that at least 25% of those that take the drugs have no diagnosed condition of depression.  And, given the panoply of side-effects (from headaches to insomnia, from dizziness to erectile dysfunction) , why would one choose to take these drugs, unless absolutely necessary?  (The Journal of Clinical Psychiatry [January 2011] reported that more than 25% of those taking the scrips have no diagnosed condition of depression.)

Which is why the next step in treatment for depression is now looming on the horizon:  the implantation of stimulating electrodes within one’s brain (deep-brain stimulation).   Given that one is implanting electrodes deep into the brain, initial studies must be done to determine short-term and long-term safety, before efficacy (clinical trials involving placebos and double blind testing) can be determined.

This implementation involves the bilateral placement of electrodes in Brodman’s area 25, an area ripe with serotonin transporters.  Brodman’s area 25 is within the cerebral cortex, in a network including the brain stem and hypothalamus (subcallosal cingulate gyrus).

This pilot study was effected by psychiatrists under Dr. Kennedy and Dr. Lozano’s surgical team (University Health Network, Toronto) published six years of results in the American Journal of Psychiatry. In a nutshell, 20 high risk (20 y of illness, suicidal) patients were treated; 12 (60%) patients demonstrated improvement for the duration (once the electrodes worked, they stayed working) and 2 (10%) succumbed to suicide.  [NOTE:  15-30% of such patients normally succumb to suicide.]  Moreover, there seems to be clinical and not just symptomatic relief as a result of the deep-brain stimulation (a reduction of 50% or greater in the Hamilton depression scale).

Some patients complained that they were no longer feeling improvement during the study, however, that was due to battery depletion.  (Once the batteries were replaced, the improvements returned.)

Given these results, a clinical trial  is now underway under the auspices of HealthCanada.  The concept is also undergoing study at other centers around the world. Medtronic and St. Jude Medical are planning similar studies for their electrode systems in the US.

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3 thoughts on “Drug-Free Depression Treatment”

  1. ‘implementation of stimulating electrodes within ones brain’ – now there’s something I won’t be rushing out to try. To me it sounds like the old days, harking back to ‘One Who Flew Over The Cuckoos Nest’. It may be great, but I will choose the pills. I just can’t mentally get past the whole ‘implantation’ thing. Conspiracy theorist partially, I don’t like the idea of having some foreign bodies implanted in me (thus I won’t have the contraceptive implant) – at least I can just stop taking a pill (with bad side effects – yes). My thinking is a bit flawed…possibly.

    Interesting article Roy. Thanks for posting as I hadn’t heard about this.
    Janine Ripper recently posted..Things to Consider Before You Volunteer

    1. Janine:
      How else can we control you???? Seriously, though, for the first few years, this technique will only be considered (unless we continue along our implementation of police states) for those that fail to achieve success with more conventional therapies. Down the road, people may opt for this for a completely different reason. The process will probably cost less than $ 1K, covered by insurance. Compare that to the drug therapy which (a) is limited by lifetime caps (b) limited to the per scrip deductible and (c) falls under psych, which has lower limits besides. And, if it works 100% of the time, vs. 75% of the people most of the time….

      There are no good answers when it comes to mental health. Because it involves personal choice, personal morality, and issues that can’t always be unequivocally evaluated.

      Thanks for your comments.
      Roy

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