Latest Treatment Approaches for MDD

Major Depressive Disorder (MDD) is a complex condition that affects many individuals worldwide. Recent advancements in treatment have introduced several promising approaches. As we explore these advancements, note that even if a treatment is FDA approved or once it is approved, that does not mean health insurance will pay for it. TMS and Esketamine are both FDA approved and covered by most insurance. This is an important distinction, but FDA approval does not automatically mean the cost will be covered by your insurance. 

Rapid acting antidepressant Esketamine is FDA approved and covered by most insurance. Traditionally used as anesthetics, esketamine has shown rapid antidepressant effects. Administered as a nasal spray, esketamine has been approved by the FDA for treatment-resistant depression. These treatments can alleviate depressive symptoms within hours to days, offering hope for those who haven’t responded to conventional therapies. 

Psychedelic therapy Psilocybin is not approved by the FDA and not covered by insurance. The active compound in certain mushrooms, psilocybin, is being studied for its potential to provide rapid and sustained relief from depressive symptoms when used in controlled therapeutic settings. Early trials suggest it may help “reset” neural circuits associated with depression. While TMS wakes up the specific area of the brain, psilocybin has been said to wake up the whole brain. 

Transcranial Magnetic Stimulation (TMS) is FDA approved for MDD and OCD and is covered by most insurance. TMS is a non-invasive procedure that uses magnetic fields to stimulate specific brain regions. 

Advancements like the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) have shown high efficacy rates, with some studies reporting nearly 80% effectiveness in controlled settings. However, the SAINT protocol is covered by very few insurance payors at this time. 

Seltorexant is an investigational drug not approved by the FDA and not covered by insurance. Seltorexant targets orexin-2 receptors and has shown promise in reducing depressive symptoms and improving sleep disturbances in late-stage trials. It offers a new mechanism of action compared to traditional antidepressants. 

These emerging treatments reflect a shift towards personalized and rapid-acting interventions, providing new hope for individuals with MDD, especially those who haven’t found relief with traditional therapies.