Week 3: Treatments for Depression

Both of the articles this week discussed different treatment options for depression. The Pollak et al. (2008) article looked at a model for behavioral intervention as a treatment for depression, while the Li et al. (2011) paper discussed the use of ketamine in depression treatment. 

Though I am a huge proponent of using behavioral intervention when treating mental illnesses, such as depression, I failed to see how the model proposed by Pollak et al. could be implemented in a human clinical population. Though learned safety training improved mouse performance on several behavioral tests (even showing to be as effective as Fluoxetine), I do not believe that learned safety could actually be used to treat depression. To me, it seems to address more of the anxiety part of depression. Also, I am not sure how it would translate to a human behavioral intervention (we can’t have humans walking around listening to a tone to make them not show effects of depression). The one part of this article that I did really appreciate, though, was that it showed that a behavioral intervention can be as effective as medication. It also showed that behavioral interventions can have biological effects on the brain. I feel as if this is a really important idea that people should pay attention to. I think that the article shows promise for behavioral interventions to have similar efficacy as medications, without many of the side effects.

I really enjoyed reading Li et al. (2011). First of all, I thought this paper was really well written and easy to understand. Additionally, I thought that ketamine proved to be a truly incredible treatment for depression. The article showed how both ketamine and Ro 25-6981 were able to reverse the behavioral effects of chronic unpredictable stress, and that mTOR activation was necessary for this effect. The paper also demonstrated the effect that ketamine has on synaptic proteins and spine density. I found it really interesting that ketamine’s effect happens so quickly, and that one dose can last for up to 7 days in rats. Though I understand that there are obviously issues regarding using ketamine as a treatment (including potential for abuse and toxicity), I think that ketamine could be used in a safe way. Many people receive weekly ECT for their depression. This is a pretty invasive procedure that involves anesthesia. Additionally, it takes a while to work, has side effects (such as memory loss and headaches), and we don’t fully understand how it helps to treat depression. It seems like ketamine treatments would almost be a preferable option to this, if delivered in an appropriate setting. Perhaps people could go to a clinical once a week to receive and injection of ketamine. It would work rapidly, and we would understand what was happening on a physiological level. Additionally, giving an injection is a much less invasive procedure than performing ECT, and abuse potential would be almost eliminated by only providing the injection in a clinic (as long as the patient cannot get it anywhere else). I thought that this paper showed a lot of promise in the treatment of depression.