Clinical depression, especially in elderly individuals, is an extremely disabling, chronic and recurrent disease; its negative impact on quality of life is significant. Moreover, during and beyond treatment, depressive symptoms often persist, even after periods of apparent remission. Depression is associated with biochemical deficiencies in the brain, accompanied by circadian rhythm disturbances associated with impaired functioning of the hypothalamus, the biological clock of the brain. Melatonin, a naturally produced hormone and Abilify, a pharmaceutical antidepressant, have both shown promise to treat this disorder. Always consult a physician before treating any mental condition.
Current Treatment for Depression
In depression, symptoms include sleep disturbances, mood alterations, sexual dysfunction, weight gain, fatigue, disinterest and anxiety, which do not often respond to current antidepressant treatments. Newer antidepressants have additional modes of action such as hormonal substitutes to act on particular receptors. Antipsychotic treatment for patients with depressive disorders has become a common intervention. Effective treatments are available, but there is a lack of consensus on the treatment of depression and long-term treatment options for related disorders. More studies are required.
Melatonin
Melatonin is a naturally occurring hormone found in mammals that is secreted into the blood by the pineal gland in the brain and plays an important role in circadian rhythms, which regulate sleep-wake cycles and other bodily functions. Normally, this light-sensitive hormone is diurnal, meaning its concentration in the blood increases at night and decrease during the day. Low or dysregulated melatonin levels can lead to sleep disorders, depression, and seasonal affective disorder among other conditions. Melatonin helps to replicate the natural circadian rhythm, which can help reestablish normal functioning and has been shown to be effective in treating depression.
Abilify
Use of antidepressants is declining, mainly due to their adverse effects. In contrast, the use of newer antidepressants, which have dual modes of action in serotinin uptake, a hormone linked to mental state, is increasing. Abilify, chemically referred to as aripiprazole, is an antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and is particularly useful in the treatment of clinical depression. It is approved by the U.S. Food and Drug Administration for its treatment of depression when used together with an antidepressant medication. Clinical studies have shown its effective antidepressant action with a relative lack of serious adverse effects.
Current Research on Melatonin and Abilify
In the January 2011 issue of "Archives of General Psychiatry," researchers sought to determine the efficacy of melatonin in elderly patients with depression. They conducted a double-blind, placebo-controlled randomized clinical trial. For the study, patients treated themselves at home or from outpatient clinics and general practitioners' offices. They found significant improvement in conditions after three weeks treatment, marked by increased sleep efficiency and mood, and confirmed by the increase in evening melatonin concentrations compared with the control group. They concluded that patients improved mood, enhanced sleep efficiency, and increased the melatonin level levels even weeks after discontinuation of treatment.
In a review article, appearing in the September 2010 issue of "CNS Neurological Disorders and Drug Targets," the authors documented several clinical trials confirming the antidepressant efficacy of aripiprazole in patients with depression. They noted there was significant efficacy even in severe manifestations, as this compound showed an efficient action as well as possessing an excellent safety and tolerability index. Furthermore, they noted aripiprazole has potential benefits in treating anxiety symptoms associated with depression and generalized anxiety disorders.
In a research article published in the September 2010 issue of "Neuropsychiatric Disease and Treatment," researchers investigated newer antidepressants and found similar efficacy with equally good tolerability profiles. Nevertheless, they noted that compliance with treatment for depression is poor and may contribute to failure of treatment. They concluded that in spite of the broad spectrum of available antidepressants, there are still at least 30 percent of depressive patients who do not benefit from treatment and suggested new approaches in drug development of antidepressants.
References
- "Neuropsychiatric Disease and Treatment"; Getting the balance right: Established and emerging therapies for major depressive disorders; B. Perovic; September 2010.
- "CNS Neurological Disorders and Drug Targets"; The Emerging Role of Melatonin Agonists in the Treatment of Major Depression: Focus on Agomelatine; D DeBeradis; September 2010.
- "Archives of General Psychiatry"; Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial; R. Liverse et al.; January 2011.
