Non-mainstream treatments
There are numerous alternative treatments for depression, whether medications
or other kinds of intervention.
Opiates Various
Opiates were commonly used as antidepressants until the mid-1950s, when they
fell out of favor with medical orthodoxy due to their addictive nature,
tolerance buildup issues and their side-effect profile. Today the use of opioids
in treating depression is a large taboo in the medical field due to associations
with drug abuse; hence, research has proceeded at a very slow rate. A small
clinical trial conducted at
Harvard Medical School in 199528],
demonstrated that a majority of treatment-refractory, unipolar, non-sychotic,
major depression patients could be successfully treated with an opioid
medication called
Buprenorphine, which is a partial mu agonist and potent
kappa antagonist. The exact mechanism of its action in depression is not
known, as appa
(κ) antagonists are antidepressants in their own right.
In 2006, The Journal of European Neuropsychopharmacology published a
follow-up study to the 1995 Harvard experiment, with results very consistent
with the original Harvard findings. Eleven severely depressed patients,
refractory to all the conventional depression treatments, were given small doses
of buprenorphine. Most of these patients found the buprenorphine to be of
significant benefit in relieving their inner torment. The researchers theorized
that "Possibly, the response to opiates describes a special subtype of
depressive disorders e.g corresponding to a dysregulation of the endogenous
opioid system and not of the
monaminergic system."
[29]
Yet another relevant scientific paper was published in the American Journal
of Psychiatry in 1999, detailing how researchers found
xycodone/xymorphone
to help 5 out of 6 'incurable' refractory severe depression patients.
[30]
While opioids have been proven to substantially relieve symptoms of
depression for a large class of patients, re-acceptance of this fact has been
severely hampered by governmental narcotic
prohibition efforts, and the (until buprenorphine) lack of alternatives with
low risk of tolerance and addiction.
Buprenorphine is generally preferred as the first-line opiate in depression
treatment, as managing the tolerance buildup of other opiates can be
complicated.
Other treatments
-
Gamma-Hydroxybutyric acid (HB)
has been used by some as an antidepressant.
Claude Rifat, a French biologist, conducted some early research into
GHB's antidepressant potential. Rifat noted that GHB did not cause the
emotional blunting effects caused by conventional antidepressants, but
instead intensified pleasurable and rewarding feelings in the user while
powerfully suppressing depression.31]
However, GHB has now been outlawed, except for use as a prescription
treatment for
narcolepsy.
- Clinical trials have shown the effect of
acupuncture to be comparable with amitriptyline; in addition,
specifically
Electroacupuncture has been found to be more effective in depressive
patients with decreased excretion of 3-methyl-4-hydroxy-phenylglycol (the
principal metabolite of the central neurotransmitter norepinephrine), while
amitriptyline is more effective for those with inhibition in the
dexamethasone suppression test.
Acupuncture has also been proven to prompt the body to produce greater
levels of
endorphins.
- Most studies conclude that
St. John's wort is usually as effective against depressions as other
modern medication, again with fewer side effects, and it is widely
prescribed for depression in Europe. A recent study showed St. John's wort
to be no more effective than a placebo in cases of severe depression,
although an SSRI was also no more effective on the primary outcome measure.
- The amino acid derivative
SAM-e has been studied in recent years
-
Tryptophan dietary supplements, although banned in many countries due to
impurities that caused a blood disease, have also been used as natural
antidepressants.Dietary supplements of
5-HTP, a chemical the body forms from tryptophan and uses to make
serotonin, have shown some promising research results but need further
study.
- MDA
antagonists such as
etamine
and
dextromethorphan have recently gained some interest in this field as
their apparent ability to reverse opioid tolerance, and can give fast-acting
dramatic effects. However, their acute psychoactive effects have been a
problem.
-
Memantine, a moderate affinity NMDA antagonist, has been used to avoid
tolerance buildup, and has seen use in opioid tolerance reversal.
Proglumide is used to induce acute reversal of tolerance prior to this
maintenance strategy; it does not work by itself in the long term, due to
tolerance to its effects.
-
Opiorphin is a very recently discovered substance that increases the
effectiveness of endorphins, meaning that it has effects similar to opioid
agonists without the addiction and withdrawal effects. While it has been
shown to be extremely effective for
analgesia, any ability to treat depression or the presence of an abuse
potential are largely informed guesswork at this stage.
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