Medication

Antidepressant medication is one of the most common treatment options for major depressive disorder. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed as they have relatively mild side effects compared to other antidepressants. Common SSRIs prescribed include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro). SSRIs work to increase levels of serotonin, a neurotransmitter that plays an important role in regulating mood. They generally take 2-4 weeks to start improving symptoms.

Other classes of antidepressants prescribed include serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor). These act on both serotonin and norepinephrine. Tricyclic antidepressants (TCAs) like amitriptyline and imipramine can also be prescribed but have more side effects than SSRIs/SNRIs. Atypical antidepressants like bupropion (Wellbutrin) work through different mechanisms. Monoamine oxidase inhibitors (MAOIs) are also options but tend to only be prescribed when other Global Major Depressive Disorder (MDD) Treatment haven't helped due to dietary and drug restrictions.

Psychotherapy

Psychotherapy, or talking therapy, is also a key treatment for major depressive disorder. Two main types are cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT aims to change negative thought and behavior patterns that may be influencing depression. It helps patients recognize when thoughts are unrealistic or unhelpful and teaches coping strategies. IPT focuses on addressing relationship issues that may be triggering or worsening depression. Short-term psychotherapies involving 12-16 weekly sessions are common.

Combined Treatment

Research shows that for moderate to severe major depression, a combination of antidepressant medication and psychotherapy leads to better outcomes than either treatment alone. Medication alone works to balance brain chemistry and relieve symptoms in the shorter term, while psychotherapy provides longer-term skills for managing and preventing future depressive episodes. A multi-pronged approach targeting both biological and psychological factors is often most effective.

Electroconvulsive Therapy (ECT)

ECT may be considered for treatment-resistant major depressive disorder that has not responded to multiple antidepressant trials and psychotherapy. It works through inducing a brief seizure in the brain under anesthesia. Multiple sessions are required, usually 3 times a week for a total of 6-12 treatments. ECT has very high response rates of around 80% for severe or psychotic depression. Cognitive side effects are the main concern but are typically temporary. ECT is generally safe but does require general anesthesia.

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