Current and Future Treatment of Depression: Glass Half Full or Half Empty?-View Presentation

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In this lecture, the speaker aimed to have a more interactive and engaging session, involving audience participation, and delivering fewer data-intensive slides, focusing instead on a broader discussion about the current state and future directions in treating major depression. The speaker humorously recounted a joke to set a lighter tone before delving into the complexities of depression treatment.<br /><br />The presentation covered numerous aspects of depression treatment, emphasizing the ultimate goal: achieving remission, akin to cancer treatment strategies aimed at completely restoring the patient to their pre-illness functioning state. The speaker criticized the limitations of current remission metrics, which often don't account for residual symptoms like sleep disturbances or concentration issues, challenging practitioners to aim beyond just statistical remission.<br /><br />The talk explored various treatment modalities, from traditional SSRIs and SNRIs to augmentation strategies with lithium or T3, and highlighted the potential of lesser-used treatments like MAOIs and pramipexole. Emerging treatments such as neuromodulation techniques like TMS and cutting-edge strategies like psychedelics were also discussed, with an emphasis on the promising, yet still largely experimental, accelerated TMS protocols.<br /><br />The speaker expressed concerns over the unrestrained rise of psychedelic therapy in non-clinical settings, pointing out the high stakes, such as triggering psychosis or mania, particularly in patients with a predisposition to such conditions.<br /><br />Acknowledging the broader systemic and economic factors affecting depression remission and relapse rates, the discussion also touched on the socioeconomic burdens of untreated depression, advocating for better resource allocation. The session concluded with an invitation for expert responses, underlining the complexity and nuance inherent in managing and treating depression effectively and ethically.

Keywords

interactive session

audience participation

depression treatment

remission

residual symptoms

SSRIs

SNRIs

neuromodulation

TMS

psychedelics

socioeconomic factors

resource allocation

ethical management