Depression
Depression goes beyond feeling sad. It can drain your energy, flatten interest in things you used to enjoy, disrupt sleep and appetite, and make everyday tasks feel heavy.
Major depression looks different from person to person. Some people feel persistently low or empty, others feel irritable or numb. Concentration, motivation, and hope itself can wear thin. It is one of the most common mental health conditions, and it often recurs, which is why ongoing care matters as much as the first visit.
Evaluation means understanding your history, your symptoms, and what you have already tried. SSRIs, the most commonly prescribed antidepressants, increase the availability of serotonin in the brain. The current understanding goes deeper than the old chemical imbalance idea: depression wears down the mood circuits until they lose flexibility, and these medications help those circuits recover and respond again, which is why they take weeks to reach full effect. Treatment is tailored to the individual and may include medication, therapy, or a combination, with progress monitored closely.
Research and further reading
A few key papers behind how this condition is understood and treated today. Links open the abstract on PubMed, a free public database from the U.S. National Library of Medicine.
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Maji et al. · Psychiatry Research · 2024
Adding dextromethorphan to an SSRI lowered depression scores more than adding placebo over eight weeks, with higher response and remission rates and similar side effects.
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Padhan et al. · Journal of Psychiatric Research · 2024
Adding sarcosine to an SSRI reduced depression scores more than adding placebo over eight weeks, with higher response and remission rates.
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Browning et al. · Lancet Psychiatry · 2025
In a 48 week UK trial, adding pramipexole to an ongoing antidepressant lowered depression scores more than adding placebo at 12 weeks, though one in five stopped it because of side effects.
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Hu et al. · Psychiatry Research · 2024
Across 35 trials, relapse after stopping medication ran about 35 percent at 6 months, and treatment lasting under 3 months raised relapse risk while treatment past 6 months showed no added benefit.
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Esketamine Monotherapy in Adults With Treatment-Resistant Depression: A Randomized Clinical Trial
Janik et al. · JAMA Psychiatry · 2025
In this randomized trial, both esketamine nasal spray doses improved depression scores versus placebo at day 28, with benefit seen as early as 24 hours after the first dose, and the most common side effects were nausea, dissociation, dizziness and headache.
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Clemens et al. · Current Medical Research and Opinion · 2025
Using patient reported symptom ratings in the ESCAPE TRD trial, esketamine nasal spray produced higher remission and response rates than extended release quetiapine at both 8 and 32 weeks.
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Zaccoletti et al. · Lancet Psychiatry · 2026
Across 76 trials, staying on antidepressants and slowly tapering with therapy support both lowered relapse risk, while stopping quickly raised relapse risk similar to stopping at once.
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Kalfas et al. · JAMA Psychiatry · 2025
Across 50 trials, stopping an antidepressant caused about one extra mild symptom such as dizziness or nausea in the first week, well below the level of a major withdrawal syndrome.
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Bartoli et al. · Drugs & Aging · 2025
In 302 older adults with depression, vortioxetine did not improve symptoms, response, or remission more than standard SSRIs over six months.
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Kato et al. · Mol Psychiatry · 2021
Across forty trials with 8,890 patients, continuing the same antidepressant after remission lowered relapse to about 21 percent compared with about 40 percent on placebo.
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