The earliest accounts of what is now known as depression appeared thousands of years ago in Mesopotamia. Depression was believed to be a spiritual affliction, and was dealt with by priests rather than physicians. As time elapsed, several doctors suggested that depression had natural causes, but they were a minority. For centuries, religion still dominated the discussion about mental illness, as well as the idea that it was the result of something supernatural. These beliefs lead to barbaric and primitive treatments, which continued for centuries.
Depression as a recognized illness did not truly emerge until the late 19th century, and into the 20th century. With it came a focus on psychotherapy as the primary treatment option. Drug therapy did not appear on the scene until the 1950s when doctors noticed that a tuberculosis medication was helpful in treating depression in some people. This discovery was the springboard for which the first true antidepressant was developed, Tofranil. Tofranil made two fundamental contributions to the field of psychiatry: it first brought about a dramatic change in the care of those experiencing depression, and secondly, it opened the door for more exploratory thinking about depressive disorders.
In the 1970s, the role of serotonin in depression was becoming evident which, was timely as there were growing concerns over the side effects of drugs like Tofranil. Scientists thus turned their attention to selective serotonin reuptake inhibitors (SSRIs). These drugs enhanced serotonin activity and presented with fewer side effects than other antidepressants. Probably the most famous development in the history of antidepressants was the FDA approval of Prozac in the late 1980s.
Prozac and Zoloft (1991) were seen as nothing short of miracle drugs. These drugs were transformative for so many people that millions of Americans embraced them. According to a New York Times Magazine article: “In 1988, a year after the Food and Drug Administration approved Prozac, 2,469,000 prescriptions for it were dispensed in America. By 2002, that number had risen to 33,320,000. By 2008, antidepressants were the third-most-common prescription drug taken in America.”
New classes of antidepressants were introduced in the 1990s that targeted the monoamine neurotransmitter system. These included dopamine-norepinephrine reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. The most common antidepressant from this group is Wellbutrin.
Despite these progressive advances in depression treatment, there are several drawbacks to these medications. All antidepressants can cause side effects including nausea, dizziness, insomnia, and sexual dysfunctions. These drugs usually take several weeks, if not longer, to really start working, and many people with depression do not respond to these drugs at all. These shortcomings demand new options for depression treatment.
Fast forward to the here and now, where psychedelic drugs are being transformed from drugs that were criminally abused to having impressive clinical applications. Recent studies have shown that they may be permanent solutions to treatment-resistant depression, PTSD, anxiety and addiction. Psychedelic drugs work opposite of SSRIs where they flood the brain’s neurotransmitters with chemical compounds that are similar to serotonin. This process essentially erases and rewrites parts of the brain’s communication network.
Today is an exciting time for the mental health field specifically in regards to depression. There are several treatment options available at ketamine treatment centers like ours, as well as many research-based clinical trials that are exploring the use of LSD, psilocybin and other psychedelic drugs. These may be the new “miracle drugs” of the future. It is going to be very interesting to see how far these drugs can take us in combatting depression as a mental illness.
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