Abstract

Treatment with antidepressants is often insufficiently effective, especially in treatment-resistant depression. In such a situation, it is possible to change the drug, add a second antidepressant, or use pharmacological and non-pharmacological methods of augmenting the effect of pharmacotherapy. New methods that may fall into the scope of multi-module depression treatment as an augmentation of depression treatment are whole body cryotherapy (WBC) and hyperbaric oxygen treatment (HBOT). 545 records were selected and analyzed for these two treatments and finally three clinical trials were selected for analysis. The review also includes data on the possibility of using WBC and HBOT in somatic indications and in organic mental syndromes. Despite the small number of studies on the effectiveness of WBC or HBOT in depression, the current data show that both methods may be effective in the treatment of depression. WBC may be effective in the augmentation of antidepressants, and additionally, it is a method in which a quick antidepressant effect is obtained. HBOT may be effective in endogenous depression, just as it is effective in the treatment of somatic depression symptoms. The results are very preliminary, but if confirmed in subsequent studies, both WBC and HBOT may become new treatment options in treating depression. The authors point to the need and directions for further research into these treatment methods as an augmentation strategy for pharmacological treatment of depression.

Highlights

  • Despite the progress in psychopharmacology and the introduction of new and effective antidepressants [1], the effectiveness of pharmacological treatment of depression is still far from satisfactory

  • Looking for evidence that whole body cryotherapy (WBC) and hyperbaric oxygen treatment (HBOT) may be effective in treating depression authors decided to review the literature, considering clinical trials, as well as case series and case reports

  • WBC may be an effective adjunct to treating depression and anxiety disorders in the short-term therapy

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Summary

Introduction

Despite the progress in psychopharmacology and the introduction of new and effective antidepressants [1], the effectiveness of pharmacological treatment of depression is still far from satisfactory. A meta-analysis by Li et al showed in patients pharmacologically treated for depression a high level of placebo response (SMD = 1.22, which indicates a very large therapeutic effect), and an increase in the placebo effect in recent years [5]. One of the most recent meta-analyzes indicates the limited efficacy of pharmacological treatment of depression in the elderly, for whom there is no statistically significant difference between treatment with an antidepressant and a placebo [6].

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