Understanding how your brain works is a good way to understand how depression medication impacts it. 

The human brain is an intricate network of interconnected cells - all functioning in precisely the correct way to enable cognition, thought, emotion, breathing, sensation, motor skills, memory, and human life and behavior as we know it. 

The brain sends and receives chemical and electrical messages from the body and within the brain itself to enable all our functional needs. Different types of signals may control different processes in the body, and your brain interprets each signal for an appropriate response. For instance, some signals can make you feel tired, while others may make you hungry.

The human brain has approximately 100 billion cells. Between these cells are gaps called synapses. To communicate between these gaps, brain cells use chemicals called neurotransmitters. 

In other words, neurotransmitters are the messengers that travel between the small spaces that separate adjacent brain cells, allowing the two cells to communicate.  Considering the sheer number of brain cells,  you can imagine how important these chemical messengers are for the brain to function. 

This chain reaction never stops and ensures that messages and signals are relayed through the vast network of brain cells. 

There are many types of neurotransmitters, including serotonin, dopamine, and norepinephrine. These are the three main neurotransmitters that are generally affected by antidepressants. However, individual antidepressants may target only one or more neurotransmitters. 

It is believed that when you experience depression, there is an alteration of signaling of one or more of these neurotransmitters in your brain. Medication classes for depression can adjust the signaling of neurotransmitters in various ways to improve your mood.  

There are various medication classes that are currently available for the treatment of depressive disorders.

Antidepressants are the most often used treatment for depression. They help balance neurotransmitters, the chemicals that transmit messages in the brain. There are many different types of antidepressants available on the market. 

Your symptoms will determine what antidepressants may be best for your situation. Sometimes, combining different antidepressants may work better than just one medicine. 

When choosing an antidepressant that's likely to work well for you, your healthcare provider may consider many various factors, including:

• Your symptoms
• Possible side effects of the drug
• Whether the drug worked for a close relative in the past
• Safety of using the medication with other medicines you are taking
• Pregnancy or breastfeeding status
• Other health conditions

While antidepressant medications may not always cure depression fully, they can be helpful in improving your symptoms.

Mood stabilizers are a category of medication used in the treatment of mood disorders, most often bipolar disorder. Bipolar disorder is when a patient has mood instability. A Bipolar patient may experience long periods of depression, but they also have periods of mania or hypomania, which can be roughly described as the extreme opposite of depression. In other words, mania is when someone’s mood and energy are too high rather than too low. 

Similar to antidepressant medication, mood stabilizers are used to balance neurochemicals in the brain. Instead of just treating or preventing bipolar depression, mood stabilizers can also treat and prevent bipolar mania. One mood stabilizer may also improve unipolar depression when used in combination with other medications for depression. 

Neuroleptics, also known as antipsychotic medications, are a class of medication used in the treatment of major depressive disorder and other psychiatric disorders, such as schizophrenia and bipolar disorder. 

There are two types of antipsychotic medications:

• First-generation antipsychotics: In use since the 1950s, these medicines work primarily by altering the signaling of dopamine, a neurotransmitter in your brain. These are also known as typical antipsychotics.
• Second-generation antipsychotics: In use since the 1990s, with newer versions still being released, these medicines also work by altering dopamine signaling. These are also known as atypical antipsychotics. They also affect the signaling of several other neurotransmitters involved with mood, including serotonin. This may be why atypical antipsychotics have more evidence for improving depression in clinical studies. 

Major depressive disorder can be difficult to treat to remission, and first-line treatments using antidepressants may not always be effective.

Major depression, therefore, frequently needs alternative treatment approaches. One such approach is modifying the treatment plan to include a second-generation antipsychotic along with antidepressant medication.

The FDA has approved four antipsychotic medications for treatment-resistant depression and major depressive disorders. They are aripiprazole, quetiapine, olanzapine, and brexpiprazole. These are usually given in combination with antidepressant medications. 

Originally used as an anesthetic, Ketamine is a rapid-acting medication that is seen to have effective results for depressive disorders that verge towards suicidal thoughts. It is also seen to reduce other symptoms of depression, such as anxiety.

Ketamine is for adults who either haven’t been helped by antidepressant pills, have major depressive disorder, or are suicidal. In such cases, patients continue on their antidepressant medication and receive ketamine at a doctor’s office or in a clinic, where a healthcare provider watches over them for 2 hours after the dose.

Although it isn’t clear how exactly Ketamine works, its antidepressant characteristics have been demonstrated in multiple trials. There are two types of Ketamine in use today: 

• Racemic Ketamine, which is not yet approved by the FDA for use as a depression treatment and is administered intravenously (IV). 
• Esketamine (Spravato), which is FDA-approved and taken as a nasal spray.

Side effects of Ketamine can include:

• High blood pressure
• Nausea and vomiting
• Dissociation
• Abnormalities in the perception of surroundings

The FDA is assessing the use of multiple different medications for treating depression. These medications, not yet approved by the US FDA for use in depression, are still available for off-label use and can be accessed when necessary.  

Off-label medication for depression includes drugs that have been approved by FDA for other uses but may have been found useful for treating depression even though depression treatment was not the original intention.

Options MD therapists consider your situation with care and in collaboration with our experts to find the best treatment options for your needs. In some cases, this can include drugs that are cutting-edge and still under consideration by the FDA for treating depression.

Pharmaceutical companies have multiple drugs under development that may help in the future with treating depression. At Options MD, our experts are leaders in their field with access to both knowledge and research material for depression medications that are at various stages of development. 

Your Options MD therapist, therefore, has access to a wide range of medications for recommendations that can place you on the shortlist for the latest and most technologically advanced treatment options.

Finding the proper treatment when you have major depressive disorder or treatment-resistant depression can be challenging. At Options MD, medications are just one of 200 treatment options that our expert team will consider when putting together a custom plan for your treatment-resistant depression. 

Options MD is here to help. Text us to start treatment now. Join our Facebook community to connect with other individuals with treatment-resistant depression.