Medicinal treatments
Medication is the first-line treatment. For the most part, these treatments act to balance the production of the neurotransmitters serotonin, noradrenaline and dopamine. Several therapeutic molecules are sometimes combined.
Recently, a new molecule, ESKETAMINE, was granted marketing authorisation as a nasal spray for the treatment of depression in the United States.
We take a look at this new drug with Professor Fossati.
However, 38% of patients do not respond to drug treatments, and 54% show no remission of depressive symptoms after 12 weeks of treatment.
Transcranial magnetic stimulation
For these so-called “drug-resistant” patients, physical treatments are envisaged.
These therapies are based on non-invasive transcranial electrical or magnetic stimulation of brain regions identified as being involved in the development of the disease.
Transcranial magnetic stimulation involves using a magnetic field in the cerebral cortex to modify the electrical activity that enables information to be transmitted between neurons. This therapy has been shown to be effective in other psychiatric and neurological disorders, and seems to work in the case of depression.
Electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT), which is slightly more invasive, is highly effective in the most severe patients. Instead of a magnetic field, this involves electrical stimulation of specific regions of the cortex.
Finally, for the most severe cases of depression, resistant to other therapies, deep brain stimulation is indicated. These are performed using electrodes implanted in specific regions of the brain, which deliver permanent electrical stimulation to the neurons in highly targeted areas of the brain, in the same way as a pacemaker does for the heart. To date, only 200 patients worldwide have been treated using this technique.
Behavioural therapies
In combination with these treatments, psychotherapies, behavioural therapies and meditation are highly beneficial in preventing recurrences of major depressive episodes.
Neurofeedback, for example, a technique used to self-relax and modify stress levels, could help improve attention disorders in depressed people.
With the aim of multiplying practitioners’ potential for action tenfold, connected and mobile objects enable remote contact with patients and the gathering of more information about them. Connected objects will make it possible to be as close as possible to patients’ living situations and to obtain information in real time so that we can carry out more detailed research that is closer to patients’ day-to-day reality.
At the Paris Brain Institute
WEFIGHT, a start-up incubated at the Institut du Cerveau et de la Moelle épinière (Institut du Cerveau – ICM), is launching ViK Dépression, a virtual companion designed to support people suffering from depression and their families as they follow their treatment.
DOCTOPSY, a start-up incubated at the Institut du Cerveau (ICM), offers an online consultation service dedicated to psychiatry, psychology, nutrition and addictology.
The HEALTHY MIND start-up, incubated at the Institut du Cerveau – ICM, is offering virtual reality headsets for use by healthcare professionals to reduce the anxiety of pre- and post-operative patients. This approach could soon be extended to patients suffering from anxiety disorders.
ADSCIENTIAM, a start-up incubated at the Institut du Cerveau – ICM, offers digital devices for continuous monitoring of disease progression in real life, to speed up therapeutic decision-making.