Patients who are experiencing repeated episodes of depression and who have already tried other treatment lines without the expected effects can be treated, for free, with a new drug that is given in day hospitalization.
Sadness can be one of the symptoms of photo depression: Pixabay
This medicine, in the form of a spray that is given nasal, has been introduced in the treatment scheme settled from last year, but not all hospitals or psychiatry sections and can offer it for free. The admission of the unit in the program, and implicitly the settlement, is done after the sanitary units of certain criteria is fulfilled, the possibility to provide services in the day hospitalization being one of the main conditions. Slatina County Emergency Hospital is the first in Oltenia to treat their patients with Spravato, one of the strengths when admission to the program is that it offers services in day hospitalization. Patients can address the hospital, based on a medical letter from the attending physician, to be included in the program, not having to have their domicile in the county.
The drug has been available on the market for a long time and can be prescribed and counter-cost, which has happened until admission to the list of settled drugs, but the cost for the patient is significant.
How are patients admitted to the program
The treatment is addressed to patients diagnosed with resistant depression. “Resistance depression is the depression that manifests itself through the recurrence of episodes. That is, it is remitted, but we do not return ad-integrum, as is the case, for example, after surgery. That is, most of the symptomatology can be remitted, but not satisfactory so that the patient can resume his functionality, resume his daily life. And then these things are quite annoying. In general, we for the health program, as a historian for the patient, have been considering at least one line or two treatment lines and which did not have a therapeutic success. This is the moment when we are thinking of starting to associate this new medicine ”explained, for “Adevărul”, Dr. Mirela Amalia Săndulescu, primary doctor, head of the Psychiatry Section of the Slatina County Emergency Hospital.
Before admitting to the program, doctors ensure that patients are somatic stable. “The biggest obstacle that the administration of this treatment could be given to us would be patients who are diagnosed with hypertension and do not control their tension values. This is a criterion of election. One of the criteria”, said the doctor. Patients also benefit from a cardiological consultation, because it requires more careful monitoring, being made a thorough evaluation before initiating treatment.
“We monitor it before administration, we monitor it after administration. There are some side effects that can occur, here it depends a lot from case to case ”, added the doctor.
After administration, the patient remains for two to three hours, or as necessary to feel safe, under the supervision of medical staff. On the day of administration it is not allowed to lead, instead the next day the drug is metabolized and the driving is allowed. In the month in which the treatment is initiated there are two administrations per week. Subsequently, in the next three it is administered once a week, and in the next two months, an administration is done every two weeks. “Here we can see exactly how each case evolves separately and we can extend the administration if at some point the results we expect. The fewer depressive episodes in the background, the faster the chances of remission are seen.” further specified Dr. Sandulescu.
“It is not a drug with spectacular results, but …”
The effect of the drug is the increase of brain neuroplasticity, which causes other drugs to the patient to be more effective. “It is not a drug with spectacular results”, Warns the doctor, and the emphasis comes because most patients expect things to change for the better. “He, somehow, aims to increase the number of dendrites that the other drugs act. Basically, the brain neuroplasticity increases and this is a process that happens over time. Studies say that the number of dendrites increases even twice after a few days after administration. But not everyone happens. I am waiting for at least three months and we see ”adds Dr. Sandulescu.
The brain of a person affected by depression, explains the doctor, fails to capture the same amount of serotonin that a person’s brain captures without this condition. This is happening in the first episodes, after which other neuromedirers, such as dopamine or acetylcholine, occur in the etiopathogenesis of depression.
“In our brain and in our body a lot of substances are secreted. At one point, the imbalance between these substances, and especially the low serotonin and dopamine secretion, it manifests clinically with depressive and anxious symptoms. And then, we come with first -line drugs. Cerebral in some functional intervals. As the number of depressive episodes increases, a part of this brain structure changes, many receptors disappear, we lose the brain. explained the psychiatrist.
In resistant depression, faster results were found, in the case of administration of this medicine, in young patients, who did not develop too many depressive episodes, and the body responds faster to this kind of stimuli. In people over 45 – 50 years old, improvements are seen after a month and a half.
Another advantage of this type of treatment is the fact that it has fewer side effects compared to the ancient classes of tricyclic antidepressants.
How we recognize depression
Doctor Amalia Sandulescu also explains how depression manifests, who is often observed first by the people in the patient’s entourage.
“We notice that it exists a state of sadness, which appears most of the day, most of the week or month: that there is a tendency to withdraw; that there is a lack of motivation and will in carrying out current activities; That there is no pleasure for carrying out these activities, including in terms of personal hygiene, food; The tendency to be perhaps restless or, on the contrary, very absent, the feeling of emotional anesthesia, no longer resonates with many things; that there are periods when they are fattening or periods when I lose a lot; Thoughts, a lot of thoughts of uselessness, guilty, can even reach these thoughts and psychotic intensity, that is, to have delusional ideas of persecution, pursuit, injury“, The doctor said. Anxious symptoms, panic attacks may also occur over the depressive picture. Insomnia may occur, decreased appetite may occur, lack of motivation, low self -esteem, etc.
“The idea is that they have to last a significant period, at least two weeks, and one of the very important criteria is that it affects our functionality, affects at least one of the important sectors of life, whether we speak of family, profession, school, in the case of students and students. There is something wrong with him ”the doctor revealed.
The percentage of those who today accept the consultation and, possibly, the treatment (if the problem cannot be remedied with psychotherapy, recommended in the first instance) is fortunately smaller, the psychiatrist said. Moreover, there are people who come on their own initiative, aware of the risks and notice that they can no longer cope with the daily challenges and the situation worsens.
“There are people from all social environments and from all age sectors. A higher percentage I think are between 30 and 60, and specific to the elderly are depressive-anxious disorders. That is, anxious symptomatology is associated quite often. Major, simple depressive disorder, without anxiety elements, is rarely encountered in the last period ”said the doctor.
