A Guide to Depression and Clinical Trials

Patients with depression usually have a positive response to treatment. However, it is important to remember that not all patients react in the same way to the same treatments. Therefore, it is possible that you will need to try different alternatives before finding a treatment that works for you. Depression is usually treated with a combination of medications and therapy.

Antidepressants are meant to regulate the brain chemistry in order to relieve depression. Although some improvement might be seen after a couple of weeks into the treatment, their full effect isn’t usually apparent until 1-3 months taking the medication, and they are usually prescribed for at least 6 months.

Antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs): citalopram, escitalopram, fluoxetine, sertraline, paroxetine, vortioxetine (approved in 2013) amongst others.
• Serotonin/norepinephrine reuptake inhibitors (SNRIs): venlafaxine, duloxetine, levomilnacipran, levomilnacipram (approved in 2013), amongst others.
• Serotonin-Dopamine Activity Modulators (SDAMs): brexpiprazole, aripiprazole.
• Tricyclic antidepressants (TCAs): amitriptyline, clomipramine, doxepin, nortriptyline, amongst others.
• Monoamine oxidase inhibitors (MAOIs): isocarboxazid, phenelzine, tranylcypromine, and selegiline amongst others.
• Atypical antidepressants: mirtazapine, bupropion, trazodone, amongst others.

There is also some clinical evidence supporting the efficacy of St. John’s Wart as a therapeutic alternative for mild depression. However, some studies have theorized that this is due to a placebo effect, and it should not be used to replace conventional medications.

Different types of psychotherapy, such as behavioral activation, cognitive-behavioral therapy, interpersonal therapy, mindfulness based cognitive therapy, and problem solving therapy are used in conjunction with antidepressants to improve the efficacy of the treatment. It might be used alone to treat mild cases of depression. Therapy can be individual, or it can involve the patient’s partner, family, or other individuals.

Electroconvulsive therapy is another form of therapy, but it is usually reserved for severe depression where other therapies have failed, and the patient has a high risk of suicide. It has been shown to be very effective in these cases, and it produces improvement faster than other forms of treatment.

• Be understanding and non-judgmental of your loved one: depression is an illness just like any other, and it is important not to stigmatize it.
• Learn the symptoms so that you can recognize the disease or any worsening symptoms.
• Get help: it is important to be aware that you might need help to deal with your loved one’s illness, too.
• Encourage adherence to treatment: make sure to talk to your loved one and express your encouragement, so that they don’t stop following their treatment.