Health Conditions

What is on the horizon?

Because the newer antidepressants are effective and widely used, most current research focuses on compounds that work like the drugs that are already on the market.

Other drug research involves products that affect dopamine or serotonin and dopamine together. Researchers are also studying a different type of drug called an alpha-1 adrenergic blocker. Drugs developed from these studies may improve mood, energy and alertness. Among the non-drug therapies being studied is one that uses the magnetic stimulation of the brain as an alternative to conventional shock treatment. Investigators are also studying the benefits of light therapy to treat seasonal depression, which can be a problem during winter months.

Because of the high public interest in herbal remedies for minor depression, the National Institute of Mental Health has launched a study to determine the safety and effectiveness of St. John's Wort, a common herbal supplement, and citalopram, a prescription antidepressant, compared to placebo. This study started in Februrary 2003 and is still ongoing. Once finished, researchers will assess the changes in a patient's symptoms, functioning, and quality of life.

A current research question is how best to maintain the benefits of electroconvulsive therapy (ECT) over time. Although ECT can be very effective for relieving acute depression, there is a high rate of relapse when the ECT treatments are discontinued. One study has compared maintenance medication therapy to maintenance ECT. This study found high relapse rates with both medication and ECT and neither was superior to the other. However, the medication regimen used included nortriptyline and lithium, which may have more side effects and may be less effective than SSRIs (another widely used antidepressant drug class). Because of this, a study comparing SSRIs to ECT or one that includes both medication plus ECT to avoid relapses may be warranted in the future.

Research continues in the quest to more clearly identify the causes of depression. Studies that are underway are examining genetic and environmental factors that may have a role in depression. A possible relationship between the substances released from the body when inflammation occurs and the onset of depression in healthy men has just recently been discovered. A study showed that men with depression had higher levels of inflammatory substances in their blood circulation than men without depression.

Another study showed that the drug, ketamine (a drug more commonly used for anesthesia during surgery), demonstrated rapid antidepressant effects. These effects were seen within hours as opposed to weeks or months for current therapy. Ketamine probably would not be the drug of choice for depression because it is used as an anesthetic and has been abused recently as a "party drug." Therefore, research has shifted to other drugs.

A study done in 2006 used Namenda (memantine), a medication currently approved to treat Alzheimer's disease, for persons with major depression. The trial was ended early because no effect was noticed; but low doses of the drug were used. Therefore, higher doses of memantine should be evaluated for major depression. Once the causes of depression are better identified, new treatments and techniques for prevention can be developed.