Ketamine, Transcranial Magnetic Stimulation, and Depression Specific Yoga and Mindfulness Based Cognitive Therapy in Management of Treatment Resistant Depression: Review and Some Data on Efficacy
Depression Research and Treatment January 1, 2015 Basant Pradhan, Tapan Parikh, Ramkrishna Makani et al. 24 citations
Depression affects about 121 million people worldwide, and major depressive disorder occurs in 6.4% of US adults. Treatment resistant depression (TRD) accounts for 12–20% of depression patients and costs $29–$48 billion annually. Ketamine and repetitive transcranial magnetic stimulation (rTMS) are useful for TRD but their long-term utility is unknown. Yoga and meditation, including mindfulness based cognitive therapy (MBCT), have been useful in treating depression and preventing relapse. This review presents rTMS, ketamine, and MBCT, and reports a depression-specific model of Yoga and MBCT (DepS Y-MBCT) that successfully ameliorated TRD symptoms in 27 out of 32 patients in an open label pilot trial. The authors suggest a tiered approach combining ketamine and rTMS for rapid remission and DepS Y-MBCT for maintaining remission and preventing relapse.