Stating that the prevalence of major depression, known as resistant depression, in the community is between 3-5.8%, Psychiatrist Dr. Instructor Member Merve Setenay İris Koç talked about the recent developments in the treatment of the disease. Noting that depression is a stubborn disease, Dr. Instructor Member Koç stated that the application of personalized treatment methods gave successful results by not leaving the person alone in this process.
BEWARE OF ENERGY DECREASES, SLEEP PROBLEMS AND APPETITE
Saying that depression (major depressive disorder) is a serious but treatable medical illness that negatively affects how you feel, how you think and how you act, Psychiatrist Dr. Instructor Member Merve Setenay İris Koç said, “It can be seen with many symptoms such as feeling sad, not being able to enjoy pleasurable situations, decrease in energy, deterioration in sleep quality and quantity, appetite changes, restlessness, loss of concentration, thoughts of death and hopelessness. Sometimes these symptoms include bodily symptoms; pain, numbness, indigestion, diarrhea, constipation, itching, palpitations etc. Therefore, people can apply to other medical branches first.”
RISK OF EARLY PARENT LOSS AND DIVORCE INCREASE
Dr. Instructor Member Merve Setenay İris Koç, early loss of parent, loss or death of a loved one, female gender, low socioeconomic level, job loss, alcohol or substance use, divorce, having a bad and traumatic childhood, previous history of depression, presence of depression in the family stated that the use of certain drugs, hormonal changes and certain diseases are the main risk factors for depression.
SHOCK TREATMENT CAN ALSO BE APPLIED
Noting that in the treatment of depression, inpatient treatment is recommended if the person has active suicidal thoughts. Instructor Member Koç emphasized that in other cases, antidepressant drugs, mood stabilizers and anxiety-relieving drugs can be used in treatment. He stated that in cases of pregnancy, breastfeeding or unresponsiveness to drugs, treatments known as shock therapy among the people called ECT can use some treatments by stimulating certain parts of the brain such as TMS, as well as methods such as psychotherapy.
APPROXIMATELY 5 PERCENT OF THE COMMUNITY IS PATIENT WITH RESISTANT DEPRESSION
Pointing out that the prevalence of major depression in the society in general is 3-5.8%, Dr. Instructor Member Merve Setenay İris Koç said, “One-year prevalence is given as 2.6-6.2%. The lifetime risk is 3-12 percent for men and 10-26 percent for women. According to Turkey Clinics Psychiatry data, Treatment-Resistant Depression (TDD) is defined as the continuation of depressive symptoms despite the use of at least 2 different antidepressant drugs for sufficient time and in sufficient doses.
DEPRESSION HAS REDUCED IN 65 PERCENT OF PATIENTS ON THE MEDICATION
Underlining that unfortunately some of the patients may have suicidal thoughts due to the loss of functionality and the feeling of hopelessness, Psychiatry Specialist Dr. Instructor Member Koç said, “In cases where we do not get a response to antidepressants and other treatments, we continue to seek fast and effective solutions for such situations. In this context, ketamine treatment has been started to be investigated by applying low doses. Recent clinical studies show that, on average, 65 percent of patients have a half-decrease in the severity of depression symptoms after the administration of the first dose.
USED IN DIFFERENT AREAS SINCE THE 1960s
Stating that ketamine has been used for anesthetic purposes since the 1960s, Dr. Instructor Member Koç shared the following information:
“Because of the fact that ketamine infusion therapy also has analgesic properties, it has been used for different purposes in the future. Studies show that Ketamine offers very promising results in treatment-resistant depression. So much so that pharmaceutical companies continue to practice different posologies of Ketamine. Currently, this drug, which is actively administered intravenously, is also planned for nasal (nasal) use in the future.”
IT IS APPLIED FOR 45 MINUTES 2-3 TIMES A WEEK
Emphasizing that there is a certain protocol in the application of the drug, Dr. Instructor Member Koç said, “Usually, at low doses, an application is made for 40-45 minutes in an area where the patient does not sleep completely, receives the drug intravenously and is kept under surveillance, and then the patient is kept under observation for a while. A rapid improvement is observed in patients, usually within a few hours of administration of the drug. This process is continued 2-3 times a week for 3-4 weeks. If the patient’s condition is suitable, the patient can return home after a certain period of observation after the procedure.
SIDE EFFECTS LIGHT AND TEMPORARY
Talking about the possible side effects of the procedure, Dr. Instructor Dr. Koç said, “Although temporary side effects such as drowsiness, vision changes, blood pressure changes and nausea can be observed for a while during and after the procedure, these side effects usually disappear within hours and can be easily tolerated when the drug dose is low. In short, side effects are mild and temporary. It is critical to increase the permanence of the procedure, to continue the cure in order to maintain the effect, to repeat 2-3 times a week, and not to interrupt the doctor’s checks by planning additional treatments.