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As science seeks answers to depression, what should patients do today?

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Now, more than one in ten Americans take depression medication — numbers that have risen during the pandemic.

But how do these drugs work – why aren’t they for everyone? Why do people suffer from depression anyway?

Experts still don’t know all the answers to these questions. After all, the brain is a complex place. But they do know that depression has its roots in everything from the genes we are born with, to our early experiences, to everything that happens in our lives now.

At the same time, they also know that many people with depression get help from antidepressants—and talk-based Therapy, better sleep, exercise, more social interaction and, in severe cases, treatments like ketamine and ECT. Help and keep trying until they find something that works for them.

That’s why Sriyan Sen, MD, Ph.D., director of the nation’s first depression center, worries about a The impact of new research on serotonin’s role in depression is getting a lot of attention.

He worries that oversimplified news stories and social media posts may lead some people to question whether they should keep taking brain-targeting serums Depression drugs of the hormone system.

The drugs, known as SSRIs, are far from perfect, he said. But there is plenty of evidence that they work for many people.

Key takeaways for people with depression

Sen mentors Eisenberg, bringing together more than 20 years of University of Michigan researchers Family Depression Center. For more than two decades, his own research has explored the root causes of depression. He is both a depression scientist and a psychiatrist who has treated many people with depression.

“Do we need to know for sure,” he said. “The biology of the brain, and how the brain differs when we’re in a depressive episode, is so complex that our current understanding is limited.”

There is no doubt that basic science, including the study of serotonin and genetic variation among people with depression, is critical in our search for the future, better treatments, and more personalized treatments. Members of the EFDC—who come from many fields at UM—are helping to lead the search.

But, Sen said, “For people who are now suffering from depression, the information we get from clinical trials should guide Nursing. Clinical trials show that SSRIs are moderately effective and play an important role in the treatment of depression, as well as other medications and psychotherapies.”

In other words, “If the treatment or combination of treatments prescribed or recommended by your healthcare provider is working for you, great – stick with it. Your personal experience with treatment is better than this Research is more important. If you are on depression medication or other therapy and are not getting relief, you are having symptoms of depression, consult your healthcare provider.”

State of the Science of Serotonin

Sen points out that mental health experts certainly don’t believe that a simple “chemical imbalance” is the root cause of depression.

Serotonin is a major brain chemical called a neurotransmitter that is body to help brain cells “talk” to each other.

A lot of people look at a lot of the earlier studies on serotonin and try to draw conclusions by combining their information.

This study did not conduct new experiments or even combine previous studies in a meta-analysis. But instead, the researchers conducted an “overall review” of some, but not all, serotonin-related meta-analyses.

Coincidentally, another “study” on serotonin and depression was published in the news the week before the report. It concluded that serotonin transporter gene variants do play a key role in depression risk combined with stressful experiences throughout a person’s life. But the study has barely gotten that much attention.

In other words, Sen says, the science of serotonin’s exact role is far from settled. Looking ahead

Sen and his colleagues hope that newer research, using modern tools, will allow scientists to Getting more information from more patients than in those older studies will accelerate progress in depression treatment.

“We now have more Good tools to see more directly the effects of neurotransmitters and changes in neural circuits,” he noted. “Furthermore, through computation, we can now combine information from multiple study levels and many patients in a way that was not possible before.”

For example, Sen and colleagues are working to determine how different combinations of genetic differences, combined with life events and current lifestyle, including sleep patterns, affect depression risk or response to treatment.

By studying people who live under stress and have different schedules—such as in the internship health study led by Sen Thousands of new physicians — they’re learning more about how these factors interact.

Meanwhile, researchers at UM and elsewhere are working on ketamine, esketamine, ECT, talk therapy and even treatment from fungi Psychedelic drugs, such as psilocybin, extracted from psychedelic drugs, to see what they do and who responds the most to them. They are looking for people with depression, anxiety and other conditions to participate in carefully controlled studies.

“The basic science is that when we’re depressed or anxious, it’s essential to recognizing new targets and understanding what’s going on in the brain. is critical and could ultimately lead to the development of new treatments that are more effective for more patients,” Sen said. “But we don’t need to understand the precise molecular mechanisms by which we act on clinical trial data showing positive effects of interventions such as improving sleep, cognitive behavioral therapy, or SSRIs.”

The future of depression treatment may be more personalized, just like cancer treatment.

“We need new medicines that work better, we need to understand how to provide the right treatment to the right patient at the right time ,” Sen said. “We all have different weaknesses and sensory activities.”



More info: Joanna Moncrieff et al, Depression The Serotonin Theory of Symptoms: A Systematic Review of the Evidence, Molecular Psychiatry (2022). DOI: 10.1038/s41380-022-01661-0

Claudia Delli Colli et al., Time Adjustment Between 5-HTTLPR Interacting and Stressing Depression Risk: Gene x Environment Interaction as a Dynamic Process, Translational Psychiatry (2022). DOI: 10.1038/s41398-022-02035-4

Citation : As science seeks answers to depression, What should the patient do today? (July 23, 2022) Retrieved September 2, 2022 from https://medicalxpress.com/news/2022-07-science-depression-patients-today.html

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