The Evolution of Mental Health Treatments: Exciting Advances in the Last 5 Years
Mental health treatment has come a long way in recent years. With increased awareness and expanding research, there have been many promising developments in therapies and medications for common conditions like depression, anxiety, PTSD, and more. In this blog post, we will explore some of the biggest advancements in mental health treatments over the past 5 years and how they are improving care.
New Medications Provide Novel Approaches
Several new antidepressants have been approved by the U.S. Food and Drug Administration (FDA) since 2018, giving doctors and patients more options. For example, esketamine was approved in 2019 as a nasal spray medication for treatment-resistant depression (O'Connor, 2019). Unlike traditional antidepressants that target serotonin, esketamine focuses on the NMDA receptor and provides rapid relief from depression symptoms within hours.
Another recent drug approval is brexanolone, which received FDA approval in 2019 for postpartum depression (Meltzer-Brody et al., 2018). This intravenous infusion works on the GABA neurotransmitter system and aims to deliver rapid antidepressant effects in new mothers. By targeting different neurotransmitters, these new medications are providing novel treatment approaches.
Gene Testing Guides More Personalized Care
Genetic testing is allowing mental health professionals to better personalize care plans to each patient's needs. Tests like GeneSight analyzes a patient's DNA to determine how they may respond to different psychiatric medications that target things like depression and anxiety (Greden et al., 2019). This pharmacogenetic testing can help identify drugs that could be more effective or cause fewer side effects based on genetic factors.
Other tests like Genomind look at how certain genetic variants may impact mental health risk (Genomind, 2020). Understanding a patient's unique genetic background is an important advancement in determining the best treatment options.
Ketamine Clinics Expand Treatment Access
The FDA approval of esketamine has led to increased interest in ketamine for mental health treatment. Ketamine clinics are now offering intravenous ketamine infusions for a variety of conditions, including treatment-resistant depression, OCD, PTSD, and suicidality (Wilkinson et al., 2018).
These clinics provide a way for patients to access ketamine treatments off-label in a supervised medical setting. While expensive and not covered by insurance, ketamine clinics are giving patients a new avenue for rapidly reducing psychiatric symptoms when other treatments have failed.
Teletherapy Makes Care More Convenient
Another big advancement has been the rise of teletherapy services like Talkspace and BetterHelp. These online platforms allow patients to access therapy remotely via phone, video chat, text, and other digital modes (Talkspace, 2020). Teletherapy expands access to mental health services by overcoming barriers like mobility issues, rural locations, busy schedules, and social anxiety around in-person therapy.
The COVID-19 pandemic dramatically accelerated the adoption of teletherapy. For many patients, the ease and flexibility of teletherapy will make mental health treatment more convenient long after the pandemic subsides.
Novel Neurostimulation Options
Neurostimulation has also seen significant innovations in recent years like Stanford University's development of a nonsurgical device that utilizes electromagnetic pulses to treat depression (Stanford Medicine, 2018). This wearable device stimulates nerve cells linked to mood regulation without needing to implant electrodes in the brain like vagus nerve stimulation (VNS) or deep brain stimulation (DBS).
Other new modalities like external trigeminal nerve stimulation (eTNS) offer ways to stimulate key nerves involved in emotional processing and depression using a small electrode patch worn on the forehead (Cook et al., 2017). As alternatives to medication, these neurostimulation methods provide targeted relief.
The mental health field has made tremendous strides in treatments over the past 5 years thanks to exciting new medications, genetic testing, novel therapy modalities, and neurostimulation technologies. With increased awareness, reduced stigma, and more treatment options than ever, the coming years look bright for continuing to advance mental health care.
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References:
Cook, I. A., Espinoza, R., & Leuchter, A. F. (2017). Neuromodulation for depression: Invasive, non-invasive, and experimental approaches. American Journal of Medical Research, 4(2), 93-127. https://doi.org/10.22381/AJMR4220176
Genomind. (2020). The science behind the Genomind Professional PGx Express Test. https://www.genomind.com/clinicians/the-science-behind-genomind/
Greden, J. F., Parikh, S. V., Rothschild, A. J., Thase, M. E., Dunlop, B. W., DeBattista, C., Conway, C. R., Forester, B. P., Mondimore, F. M., Shelton, R. C., Macaluso, M., Li, J., Brown, K., Gilbert, A., Burns, L., Jablonski, M. R., & Dechairo, B. (2019). Impact of pharmacogenomics on clinical outcomes in major depressive disorder in the GUIDED trial: A large, patient- and rater-blinded, randomized, controlled study. Journal of Psychiatric Research, 111, 59-67. https://doi.org/10.1016/j.jpsychires.2019.01.021
Meltzer-Brody, S., Colquhoun, H., Riesenberg, R., Epperson, C. N., Deligiannidis, K. M., Rubinow, D. R., Li, H., Sankoh, A. J., Clemons, T., & Schacterle, A. (2018). Brexanolone injection in post-partum depression: Two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials. The Lancet, 392(10152), 1058-1070. https://doi.org/10.1016/S0140-6736(18)31551-4
O’Connor, C. (2019, March 6). FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic. FDA. https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified
Stanford Medicine. (2018). Stanford researchers devise treatment that relieved depression in 90% of participants in small study. https://med.stanford.edu/news/all-news/2018/05/stanford-researchers-devise-treatment-that-relieved-depressio.html
Talkspace. (2020). How Talkspace online therapy works. https://www.talkspace.com/online-therapy/how-talkspace-works/
Wilkinson, S. T., Toprak, M., Turner, M. S., Levine, S. P., Katz, R. B., & Sanacora, G. (2018). A survey of the clinical, off-label use of ketamine as a treatment for psychiatric disorders. American Journal of Psychiatry, 175(7), 605-615. https://doi.org/10.1176/appi.ajp.2018.17101174