What is interventional psychiatry?

Interventional psychiatry is an emerging field that focuses on procedural treatments in difficult-to-treat mental health conditions. These interventions are typically noninvasive and don’t require hospital stays.

You might benefit from interventional psychiatry if you’ve tried more traditional treatments, such as antidepressants and talk therapy, but didn’t get better. You might also turn to interventional psychiatry if you’re interested in alternatives to pharmaceuticals for managing your condition, especially if you experience unpleasant side effects from medications.

There is no standard definition of what procedures and therapies fall under interventional psychiatry, but generally they fall into two accepted categories:

• Neurotechnologies that apply brain stimulation to alter dysfunctional brain activity responsible for psychiatric disorders
• Therapeutics that are administered following a structured protocol and require monitoring by trained medical professionals

Some of these treatments have been studied and available for decades whereas others are just gaining approval from the U.S. Food and Drug Administration for use in the mental health clinical setting.

Interventional psychiatry has allowed the psychiatric toolbox to expand and improve mental health care. Exploring these alternatives and providing access to them is very important, because these conditions can greatly impact someone’s quality of life and even become life threatening.

Interventional psychiatry methods offered at Ohio State

The behavioral health experts at the Ohio State Wexner Medical Center have a number of advanced treatments that might help you. That’s one of the reasons why we’re so successful at helping people with severe depression and other mood disorders.

Here are some of the novel mental health therapies we offer:

Transcranial magnetic stimulation (TMS)

Transcranial magnetic stimulation uses magnetic pulses to stimulate areas of the brain believed to control emotions and concentration. These areas may not be functioning properly for people who are experiencing depression. Sessions, which are conducted on an outpatient basis, are well tolerated, without the need for anesthesia, and last just a few minutes. You’re able to resume normal activities upon leaving therapy.

Treatments are typically scheduled five days a week for four to six weeks.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy is conducted while you’re under general anesthesia, meaning you’re asleep and can’t feel pain. ECT uses electricity to trigger a brief seizure, which can lead to improvements in depression.

You’ll awaken several minutes after ECT and won’t remember the treatment. More than half of people with severe depression improve dramatically, and many do not have symptoms at the end of the treatments provided.

Ketamine infusion therapy

Ketamine is used in high doses for anesthesia; however, lower doses have been shown to improve depression symptoms. It can be a rapid-acting treatment, working after one or two treatments for some people.

The therapy is administered as one infusion or a series of infusions, usually intravenously. Sometimes ketamine is given as an injection under the skin.

Intranasal esketamine treatment

This form of ketamine is an FDA-approved nasal spray in which you inhale. Intranasal esketamine (Spravato) must be used in the doctor’s office so you can be monitored. It’s typically used alongside a traditional antidepressant. It carries the same benefits as other forms of ketamine and is covered by most insurance policies.

Vagus nerve stimulation

Vagus nerve stimulation (VNS) activates a nerve in the neck connecting the brain to the heart. Unlike other therapies, vagus nerve stimulation starts to work in deeper structures of the brain and extends upward and outward to the surface. The treatment has been studied in people who have very difficult-to-treat symptoms. Before administering this therapy, physicians implant an adjustable pulse generator in the chest. It connects to a wire that’s threaded beneath the skin and wound around the left vagus nerve. Vagus nerve stimulation is not a rapidly acting treatment but can offer stable benefits for years or decades of a person's life.

How to get a referral for interventional psychiatry

It’s important to remember that interventional psychiatry isn’t typically the first line of treatment offered. Usually, these interventions are recommended after traditional therapies, like medications or talk therapy, haven’t adequately improved your symptoms.

To begin the initial evaluation process to find out if you could benefit from interventional psychiatry, call our mental health specialists at 614-293-9600.