(If you only suspect that you have depression and have not yet been treated - read here)
Depression is a common problem that is often treated with antidepressants. However, many people do not get better after treatment with these drugs. According to statistics (for example, a 2021 study published in the Journal of Clinical Psychiatry), almost a third of patients "do not respond" to first-line therapy - the effect of prescribed antidepressants is absent within 1-3 months after the start of treatment. This condition is called therapeutically resistant or pharmacologically resistant depression.
Although there is some disagreement about the definition of treatment-resistant depression, such a diagnosis is usually given to patients who do not respond to adequate doses of two different antidepressants taken for a sufficient period of time - usually six weeks. Therefore, doctors have to change or combine drugs, which increases the risk of side effects. reactions But even in this case, it is not always possible to achieve a stable remission, and even more so, a full recovery.
It's impossible to predict exactly who will be resistant to treatment, but researchers have noticed that some populations are more vulnerable than others. For example, women and the elderly seem to be more likely to experience TRD due to reasons related to biological and psychological factors. Those with severe or frequent bouts of depression were also more vulnerable. The general state of health of a person who has experienced depression, substance abuse, eating and sleep disorders can also play a role, which increase the likelihood of decreased susceptibility to antidepressant treatment.
Also possible reasons for this phenomenon are:
- Inadequate antidepressant therapy – wrongly selected drug, its dose or insufficient duration of treatment;
- Non-compliance with the doctor's recommendations due to low motivation for therapy. As a rule, this happens due to the fact that the specialist could not find an approach to the patient, which caused mistrust and reluctance to continue consultations.
- Sometimes a person refuses to take medicine because he sees benefits in his depressive state (attention from relatives, lack of need to work, etc.).
- A fairly common reason for refusing therapy is various side reactions
- The presence of factors that support a depressive syndrome, for example, unresolved conflicts in the family and at work, existing financial problems, lack of housing
- An incorrect diagnosis or concomitant mental disorders that provoke the recurrence of depressive symptoms
- Taking other drugs that reduce the effectiveness of antidepressant therapy
There are several main treatment options for resistant depression. For example, adding other drugs to the drug regimen, psychotherapy, electroconvulsive therapy, etc.
Transcranial magnetic or electrical stimulation of the brain is increasingly being used.
But psychedelic therapy, in particular with the help of ketamine, the only legal medical drug that has psychedelic properties, looks the most promising today. Many studies have already been conducted that demonstrate the high effectiveness of ketamine therapy in anxiety-depressive disorders. It is especially effective in treatment-resistant depression and PTSD.
For example, in the recently published in 2022 in the "International Journal of Molecular Sciences" article "The concept of tapering (persistence) in treatment-resistant depression: a focus on ketamine” discusses the revolutionary use of ketamine as a game-changing tool in the treatment of persistent depression.
The study reveals the profound effects of ketamine on individuals who have experienced the devastating effects of resistant depression. It involves the strategic administration of ketamine to effectively restart the brain's neuronal pathways and alleviate symptoms of depression. By affecting the underlying mechanisms of disease, ketamine offers hope where other methods have failed.
What makes ketamine even more promising is its ability to circumvent the limitations of traditional antidepressants. Unlike conventional methods that can take weeks or even months to show noticeable results, ketamine works quickly to relieve people during depressive episodes. This opens up a new world of possibilities for those desperately seeking relief from the heavy burden of resistant depression.
In addition, the study emphasizes the safety and tolerability of ketamine when administered under the supervision of medical professionals. By analyzing in detail the experiences of patients who received ketamine treatment, the researchers confirm its potential as a well-tolerated intervention with mild and transient side effects.
The implications of this research reach far beyond the scientific community. It is a call for a paradigm shift in mental health care, a call for health professionals and policy makers to consider alternative options for those who have exhausted traditional approaches. With the help of ketamine, we have the opportunity to rewrite the history of treatment-resistant depression, offering a renewed sense of hope to millions of people around the world.
The Expio Center is the first and only medical institution in Ukraine that legally uses ketamine psychedelic psychotherapy since 2018.