Depression Research at Mount Sinai
Experts at Mount Sinai’s Mood and Anxiety Disorders Program (MAP) are conducting innovative studies and clinical trials to develop new depression treatments, unravel the biology of depression, and better understand the burden of this disease on family members.
New Pharmaceuticals to Treat Depression
Current antidepressant medications generally affect the same family of neurochemicals, and don’t prove effective for all patients. MAP is conducting several pharmaceutical clinical trials to develop new medications that work differently, such as the following.
This pharmaceutical acts on the important glutamate system, and is traditionally used as an anesthetic, but Mount Sinai researchers have shown it has promising and rapid antidepressant effects.
This pharmaceutical is traditionally used as an antibiotic, but may have promising antidepressant effects in bipolar patients.
- Other new drugs under evaluation
In association with the pharmaceutical industry we are testing several novel molecules with new mechanisms of action and promising antidepressant effects (including two different agents that modulate the glutamate system, and one agent acting on serotonion, norepinephrine, and dopamine systems simultaneously).
New Device-Based Therapies for Depression
The procedures in this growing field of therapy are largely intended for severe, treatment-resistant depressive disorders. Mount Sinai is involved in several device clinical trials, such as the following:
- Electroconvulsive Therapy (ECT)
While ECT is a proven therapy that has long been in use, Mount Sinai is currently leading the largest multicenter ECT trial funded by the National Institutes of Mental Health to further study it. Called PRIDE, the trial is focused on ECT used for geriatric depression. Mount Sinai is also planning ECT studies to refine the procedure and optimize clinical application.
- Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation (TMS) will be used in the nearby future at Mount Sinai Medical Center to treat major depressive disorder that is not well controlled by medication or psychotherapy. A magnetic coil is positioned against the patient's forehead, generating a pulsating magnetic field that is able to improve the communication between certain areas of the brain. These pulses are not painful and rTMS is relatively well tolerated and associated with few side effects. The treatment consists of at least 20 rTMS weekday sessions.
- Vagus nerve stimulation (VNS)
Vagus nerve stimulation is used at Mount Sinai Medical Center to treat major depression that is not well controlled by medication, psychotherapy, rTMS or ECT. Approximately 40 to 50 percent of patients who undergo this procedure for depression report a significant reduction of symptoms.
- Deep Brain Stimulation (DBS)
Mount Sinai is currently studying an emerging treatment called Deep Brain Stimulation, which involves implanting a wire that sends electrical signals to targeted areas deep in the brain in order to alleviate a number of disorders, including severe chronic depression and OCD.
New Psychotherapies to Treat Depression
Mount Sinai is currently testing an innovative computer software that guides the user through psychotherapy exercises. Based on the fact that many depressed patients have a tendency to perceive things negatively, this technology helps patients correct their thought patterns by displaying images and evaluating the user’s assessment of those images. While still under development, the program may prove to be an efficacious, inexpensive, and easily accessible psychotherapy for depression.
Developing Help for Caregivers
While traditional therapies are focused on the patient, there is a larger group of people (including caretakers and family members) who carry the burden of illness. Mount Sinai is currently conducting research illuminating the impact of depression on family members and evaluating potential strategies to alleviate the burden of mood disorders (such as bipolar disorder) on caretakers.
Researching the Biology of Depression
MAP is currently conducting structural MRI, functional MRI (fMRI) and magnetic resonance spectroscopy (MRS) studies that collect data about brain structure, function, and chemistry in depressed subjects before and after treatment with various antidepressant treatments. The studies seek to identify the changes in the brain that result from these therapies, not only to determine the effects of each treatment, but also to better understand the biology of depression itself.