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New Treatments for Depression

Depression Treatments: Ketamine, Propofol, Nitrous Oxide, Psychedelics, and Transcranial Magnetic Stimulation. What Is the Evidence?


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By Stuart M Caplen, MD


In 2020, an estimated 8.4% of the US adult population (21 million adults) and 12% of the U.S. population aged 12 to 17 (2.9 million adolescents) had at least one major depressive episode. Depression with severe impairment is defined by a two week or more period of depressed mood or loss of interest or pleasure in daily activities, with many associated symptoms such as problems with sleeping, eating, energy, concentration, or self-worth.[1]


Depression is typically treated with a combination of antidepressants and psychotherapy. However, only 40 to 70% of depressed patients respond to these treatments, and about 10% to 30% of patients with a major depressive disorder develop severe treatment resistant depression (TRD).[2] In the past, electroconvulsive therapy (ECT) was used as the main treatment when other methods had failed. Recently, other modalities such as ketamine, propofol, nitrous oxide, psychedelics, and transcranial magnetic stimulation have been evaluated as alternative treatments for severe TRD to avoid the potentially severe side effects of ECT. This article will look at how successful those modalities are in treating TRD, and the level of scientific evidence for their usefulness.



  • Ketamine

  • Propofol

  • Nitrous Oxide

  • Psychedelics

  • Transcranial Magnetic Stimulation


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ABOUT THE AUTHOR

Stuart M. Caplen, MD, FACEP, MSM

Dr. Caplen is a retired emergency medicine physician and former emergency department medical director, who also has a Master of Science in Health Care Management degree, and green belt certification in Lean/Six Sigma.


References


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