With ketamine and botox against depression progress in treatment swr2

It can take a long time to find the right medication to treat depression. Ketamine and Botox seem to help quickly, but need more research.

Probability of responding to an antidepressant is 40 percent

Medication is the standard treatment for depression: They help some sufferers, but very many do not help at all. Accordingly, the controversy surrounding its use is great. A review of the literature shows a stalemate between the proponents and the skeptics.

According to Martijn Arns of Utrecht University, the likelihood of responding to an antidepressant is about 40 percent, only ten to 15 percentage points higher than the proportion of those who respond positively to a placebo. Only about half of the people get better for more than half a year.

Antidepressants can be addictive

A low chance of success would not be such a big problem if, on the other hand, there were not so much to lose: current antidepressants can cause problems in the long run. The body gets used to it like a drug. Therefore, some patients experience a kind of withdrawal when they stop taking the medication.

These factors must be contrasted with the severity of the condition: Depression can be so distressing that even a small chance of success is a glimmer of hope.

Further information on depression

M.A. Busch u. a.Prevalence of depressive symptoms and diagnosed depression in adults in Germany, Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 56, No. 5 (1. May 2013): 733-39

M.P. Hengartner, J. anxiety, and W. Rossler: Antidepressant Use Prospectively Relates to a Poorer Long-Term Outcome of Depression: Results from a Prospective Community Cohort Study over 30 Years, Psychotherapy and Psychosomatics 87, no. 3 (2018): 181-83

Cathleen O'Grady: Botox depression treatment raises eyebrows. Science 372, no. 6549 (25. June 2021): 1378

Jean Kim u. a.Esketamine for Treatment-Resistant Depression – First FDA-Approved Antidepressant in a New Class. New England Journal of Medicine 381, no. 1 (4. That's why researchers are looking. Researchers continue to search for new cures. They are also testing drugs that have proven effective for other problems and that one would not expect to be used for depression, such as Botox and ketamine.

Botox smoothes out frown lines and probably has a positive effect on depressive feelings

Botox is the highly potent toxin of a bacterium. It is injected into the forehead, or more precisely: the glabella region. This is also known as the "frown line". Thus, the ability to express anger or sadness is reduced. It is not yet certain that depressive feelings are already diminishing because they can no longer be expressed. Indirect effects, such as the positive reaction of fellow people to a friendly facial expression, are also being discussed. What's more, the injection could have immediate chemical consequences for the brain. Based on initial positive results, such questions should be clarified before Botox is approved for the treatment of depression.

The frown line of the glabella region is located between the eyebrows. Treating them with Botox is said to have positive effects on people with depression. The exact mechanism of action is not yet known. To be explored in further studies. imago images imago images / Ikon Images

Ketamine can act particularly quickly

Ketamine is currently causing a lot of excitement in depression treatment. It's available on the black market as a drug, but it's actually a painkiller and anesthetic that has been used in surgery for decades. By chance, it was found that the mood of depressive patients lifted only a few hours after surgery when ketamine was used. With common antidepressants, on the other hand, the effect often only begins after several weeks. Based on long medical experience with ketamine, side effects can be excluded. But here, too, further studies are needed before a corresponding treatment is covered by health insurers.

Precision medicine: treating sufferers with the right drug

It is usually not clear which patients are helped by which medication. Being able to make accurate predictions here is the goal of precision medicine. Brenda Penninx of the Free University of Amsterdam, for example, talks about being able to "distinguish two or three relatively homogeneous subgroups of patients". Only one group with severe symptoms shows an overactive immune system, which should be treated specifically.

Martijn Arns of Utrecht University uses the EEG to study the relationship between brainwave patterns and treatment successes. Using electrodes, he measures the brain waves of affected individuals and classifies them according to frequency, asymmetry and a special type of brain activity that is also found in cases of epilepsy. He hopes to be able to predict which drugs will help best – but also whether stimulation of the brain with electric current or psychotherapy will be more successful.

With the help of electroencephalography (EEG), brainwave currents can be recorded. For this purpose, electrodes are attached to the head. Martijn Arns hopes that this will lead to more success in the targeted treatment of depression. imago images imago images / Science Photo Library

Dealing with one's own suffering in the right way is part of recovery

Due to the difficulty of determining a suitable treatment, it seems all the more important that those affected, for example in the context of behavioral therapy, can learn to come to terms with and deal with their suffering.

The US-American author Andrew Solomon has taken the reflection on his own depressive suffering as a starting point for a non-fiction book. "Saturn's shadow" became a bestseller, thanks in part to Solomon's personal accounts.

Today he hopes to take a pragmatic perspective on this aspect of his life. He says: "Now I have the feeling that I can be sad and restless, but I can say to myself: Okay, right now I feel terrible, I feel sad, but that's about it.

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