According to the CDC, 16 million adults will suffer from depression this year. This illness has a negative impact on mood, thinking and behavior. It takes the joy out of activities that are normally pleasurable. As a result, depression affects not only one individual, but that person’s family and social network. Over a lifetime, 1 American out of every 6 struggles with depression at some point. Although scientists thought they already knew a lot about this affliction, researchers have just uncovered a new and different type of depression.
Some Antidepressants Don’t Work Well for New Type of Depression:
Psychiatrists and other healthcare providers usually treat depressed patients by prescribing antidepressants. Unfortunately, many people do not respond to conventional medications such as fluoxetine (Prozac) or paroxetine (Paxil). When doctors recommend these drugs, they may explain that the medicines correct a chemical imbalance in the brain. Lately, though, neuroscientists have questioned this popular idea.
Why Do People Have Trouble with Antidepressants?
In a study at Stanford, 27% of patients with depression did not improve on sertraline, venlafaxine or escitalopram (JAMA Network Open, June 15, 2023). The original study included more than a thousand individuals with major depressive disorder. As part of the clinical trial, 96 of them volunteered for brain imaging with functional magnetic resonance (fMRI).
The researchers identified many of these non-responding individuals as having a different type of depression. Their performance on cognitive tests and depression scales shows that they have trouble with memory, attention, self-control and reflexes. Brain imaging reveals that the cognitive control circuit does not activate itself appropriately. (For brain nerds, this circuit is located in the right dorsolateral prefrontal cortex.) Most importantly, these individuals did not improve until their cognitive changes were reversed. As a rule, serotonin-based antidepressants do not affect cognition.
According to these researchers, as many as 5.7 million people may be affected by this type of depression. Because most modern antidepressants may work through a similar mechanism, doctors do not have many options to help such people. The investigators suggest that therapies targeting cognitive dysfunction might work better.
What Do You Think?
Have you experienced depression? If so, did you find an antidepressant helpful? Did you notice difficulties with concentration or memory? Tell us about your experience in the comment section.
