Transcranial magnetic stimulation is one of the treatments available locally for people with depression who do not respond to antidepressants

Clinical leaders in Northamptonshire have published new treatment guidelines designed to improve health and wellbeing outcomes for people with depression.

The new depression pathway draws on the latest evidence around safe and effective use of antidepressants and other methods of treatment.

It has been developed by county mental health specialists with input from GPs, pharmacists and patients, and approved by NHCP’s Strategic Clinical Group of senior clinicians representing Northamptonshire’s key health and care organisations.

Research has shown that people with depression who fail to respond to two different antidepressants alongside psychological therapy have only a small chance of responding to a third or fourth antidepressant.

Northamptonshire’s new depression pathway therefore provides guidance for health professionals to reduce variation in the types of antidepressant prescribed across the county, and ensure that the safest and most effective drugs are always used.

People whose depression is found to be difficult to treat (and they have failed to respond to two or more antidepressants and pyschological therapy) can be offered alternatives to antidepressants under the new guidelines.

In appropriate circumstances and subject to qualifying criteria being met, GPs may refer these patients for treatment from Northamptonshire Healthcare NHS Foundation Trust’s Centre for Neuromodulation at Berrywood Hospital in Northampton.

The treatments available include transcranial magnetic stimulation (pictured above right), ketamine infusion, transcranial direct current stimulation and vagus nerve stimulation, which are more likely to be effective where antidepressants have failed.

For example, around 50% of “difficult to treat” patients can see their depression symptoms reduced to zero after treatment with transcranial magnetic stimulation, according to data from the Centre for Neuromodulation.

The depression pathway also includes treatment guidelines for people with diabetes and chronic obstructive pulmonary disease (COPD) as these physical conditions are known to have a worse outcome in people who are depressed.