The UC Davis Department of Psychiatry and Behavioral Sciences opened its new Advanced Psychiatric Therapeutics (APT) Clinic this week. Located on the Ambulatory Care Center on the Sacramento campus, the ability is devoted to treating sufferers with treatment-resistant despair.

“Depression is, unfortunately, a common and potentially devastating illness, and it’s becoming more common each year in the United States,” mentioned Katharine Marder, a psychiatrist at UC Davis Health who focuses on treatment-resistant despair. “While medications and talk therapy are effective treatments for many people, we also know that one in three people with depression won’t respond to those standard treatments.”

The APT Clinic presents two new remedy choices: transcranial magnetic stimulation (TMS) and esketamine nasal spray.

TMS is a non-invasive remedy that makes use of mild pulses of magnetic fields to stimulate nerve cells within the mind. It works in another way than customary antidepressant drugs, like serotonin reuptake inhibitors (SSRIs), however with out their undesirable unwanted effects similar to weight modifications and sexual dysfunction.

Esketamine (model identify Spravato®) is a nasal spray derived from ketamine. Ketamine is believed to enhance signs of despair by serving to to revive connections between nerve cells within the mind. Esketamine is run below supervision in a clinic as a result of potential for unwanted effects together with sedation or dissociation.

Both choices deal with main depressive dysfunction and have good response charges. Compared to plain drugs for despair, which may take weeks to months for sufferers to see enhancements, the outcomes with esketamine might be fast, with some sufferers feeling enchancment inside days.

“As a provider, it’s sad and frustrating when you have patients who have been depressed and are not getting better,” mentioned Debra Kahn, director of the brand new clinic and a professor and scientific psychiatrist within the Department of Psychiatry and Behavioral Sciences. “It’s exciting to have these new treatment options, and it makes us feel hopeful that we can help people that we haven’t been able to help before.”

Candidates for these remedies are adults who’ve tried two different antidepressants with out vital enchancment. Physicians work with sufferers to find out eligibility and to debate the dangers and advantages of every earlier than formulating a remedy plan.

For TMS, sufferers typically obtain day by day remedies for the primary six weeks, adopted by a three-week taper part during which the frequency is steadily diminished to as soon as per week earlier than remedy is accomplished. Treatment durations typically final from 5 minutes to half-hour, relying on the protocol prescribed for the person affected person.

For esketamine, sufferers will typically obtain remedy twice weekly for the primary month, as soon as weekly for the second month, and as soon as each one to 2 weeks for upkeep remedy. During their go to to the clinic, sufferers self-administer the nasal spray after which spend a few hours in a soothing surroundings whereas the medicine takes impact.

New location in 2025

The clinic’s house within the Ambulatory Care Center is non permanent. UC Davis Health has leased a 15,000-square-foot everlasting area on the Cannery Business Park in East Sacramento, a few mile from UC Davis Medical Center.

The bigger facility within the Cannery is present process a $20 million renovation and is predicted to open subsequent 12 months. It will present the power to deal with extra sufferers and for sufferers to take part in scientific trials, together with psychedelics as a remedy for despair.

“The treatment options for mental health disorders like depression were very limited for many years,” mentioned Helen C. Kales, chair of the Department of Psychiatry and Behavioral Sciences. “But that is changing. We are entering a new era for psychiatry, with promising new medications and treatment options. We are excited to be offering esketamine and TMS for our patients and look forward to offering other new and effective treatments in the future at our new location.”

In addition to Kales, Kahn, and Marder, the TMS-certified psychiatrists offering remedy on the new clinic are John Onate, Lorin Scher, Amy Barnhorst, James Alan Bourgeois and Manpreet Singh. Additional members of the care crew embrace Matthew Settle, a psychiatric nurse practitioner; Donna McDonald, a nurse supervisor; and Leticia Diaz and Mary Lomu Lilomaiava, TMS technicians.