New treatment involving ultrasound technology shows promising results for those struggling from treatment resistant depression.
Over the past 7 years, Sky Zazlov has been fighting treatment resistant depression, meaning none of the medication or wide variety of other treatment methods or interventions have been able to lift the black cloud looming over her head every day of her life.
The medications themselves present a big problem. A fairly recent example of this kind of corruption comes from a study that was published in the British Medical Journal by researchers at the Nordic Cochrane Center in Copenhagen. The study showed that pharmaceutical companies were not disclosing all information regarding the results of their drug trials. You can find the link to that study and read more about it here.
Zazlov said in an interview with CTV News, “It affects hygiene, sleep, diet, emotions,” Zazlov, 40, said of the severe treatment-resistant depression she developed in 2011.
“It affects everything, how I interact with my family, whether I’m able to keep friendships, whether or not I can get out of bed and wash my hair and brush my teeth,” said the mother of a 12-year-old boy, who is no longer able to work as a 911 dispatcher in Toronto.
“You feel numb sometimes and empty a lot of the time. There’s not a lot of interest in doing anything or seeing anybody or talking to anyone.”
The previous sentiments are hallmarks of those suffering from major depression. This illness affects about one-quarter of the Canadian population. Around 14 percent of people will suffer from recurrent bouts of severe depression and among those about 1 in 10 will not respond to at least three of the standard anti-depressant medication and treatment and thus, are deemed to be treatment resistant.
“Nothing has worked well, nothing has even worked OK up to this point.”
Zazlov agreed to take part in a six-week patient clinical trial of a new procedure that utilizes ultrasound technology directing the beams into the brain to alter one of the pathways that is known to be partially responsible for the psychiatric conditions such as depression, obsessive-compulsive disorder and post traumatic stress disorder.
Zazlov was the third patient with intractable depression to be treated at Sunnybrook Health Sciences Centre with the MRI-guided focused ultrasound. This method is a non-invasive procedure that sends more than 1000 beams through the skull to a specific and tiny target in each hemisphere of the brain.
The focused beams, pinpointed to four-to-five millimeter areas of her brain, create a lesion in the region called the anterior limb of the internal capsule. Essentially this is the circuit or information highway connecting the frontal lobes to the emotional centres that lie deep within the brain.
The goal is to “disrupt the activity in a circuit that’s not functioning properly, to effectively reset the activity of that circuit,” said Dr. Nir Lipsman, principal investigator of the trial, the first in North America to use focused ultrasound to try to overcome treatment-resistant depression.
“The best part of this surgery is that it’s non-invasive,” said Lipsman.
No holes need to be drilled into the skull and there are no probes being poked at the brain, this is an MRI-guided focused ultrasound.
“Now we can generate the same lesion under real-time image guidance without making an incision,” he said.
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How Effective Is It?
Now, we wait. To see whether or not the procedure is effective, it will take several months according to Dr. Anthony Levitt, director of the hospitals’s brain sciences program and trial co-investigator.
“What I anticipate us seeing in the earliest stages is some change in mood, not necessarily positive or consistent,” he said of Zazlov and the other trial participants.
The patients won’t “necessarily feel wonderful and fabulous and recovered … but in that first two months you can see a variety of changes, just evidence that we have tampered with the mood-regulating system. It hasn’t yet adapted itself, it hasn’t come to a settled place, which takes two to six months or more.”
Zazlov said that she enrolled in the trial because at this point she feels she has nothing to lose, even if the results of this treatment are unknown.
“I’ve done so many trials of medications, different classes of medications,” she said, before listing a variety of different therapies she has tried including, group counseling, cognitive processing for trauma, rounds of repetitive transcranial magnetic stimulation.
“I’m not looking for a magic pill, I’m not looking for a magic bullet … I would like to think that this has the potential to make me somewhat OK, Zazlov said of the ultrasound procedure.”
“I’m hoping that I can have a day where I can get out of bed and I can have a day where I can not feel so hopeless and feel that despair — its brutal.”
“I’d like,” she said pausing with a sigh “to be able to live.”
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It’s also important to note the pharmaceutical drug aspect in this equation. One small example out of many, is when American psychologist Lisa Cosgrove and others investigated Financial Ties between the Diagnostic and Statistical Manuel of Mental Disorders (DSM) panel members and the pharmaceutical industry. They found that, of the 170 DSM panel members 95 (56%) had one or more financial associations with companies in the pharmaceutical industry. One hundred percent of the members of the panels on ‘mood disorders’ and ‘schizophrenia and other psychotic disorders’ had financial ties to drug companies. The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders. In the next edition of the manual, it’s the same thing. (source)(source)
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