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Let’s Talk About Depression


Major Depressive Disorder

Glutamate is a brain receptor with many vital functions to perform with the nervous system development, including learning and memory. When there is glutamate impairment, it results in various mental health disorders such as Alzheimer’s and Parkinson’s diseases, stroke, epilepsy, schizophrenia, and depression.


Glutamate brain receptors act as an entry portal to allow charged atoms or molecules to enter the nerve cells. When glutamate starts the binding process, sodium potassium and sometimes calcium start to gravitate into the cells.


This process is what helps the nerve cells to activate signals. Metabolic studies have found that the majority of glucose that enters the brain is converted into glucose. The glutamate receptor has three major characteristics, a resting condition, an active condition, and a desensitised condition


Esketamine also helps glutamate efficiency in the prefrontal part of the brain; this is where executive functioning resides. This area is critical; much action takes place here, such as:


  • Concentration
  • Organisation
  • Judgment
  • Reasoning
  • Decision-making
  • Creativity
  • Emotional intelligence



Most patients who are given antidepressants for mental health disorders, including major depression, are left with residual symptoms and other side effects. Brain diseases that impair neurotransmitters serotonin, norepinephrine, and dopamine have been the main focus of research over the last 50 years. However, brain neurons do not regard these three neurotransmitters as their primary focus.

Women tend to suffer more from major depression compared to men. Depression is a significant factor in suicide deaths. Women mostly carry out suicide attempts, but more men die from suicide at 75% than women at 25%. Drug and alcohol misuse increases the risk of suicide attempts.


Electric convulsive treatment is used for people suffering from major depression; however, not everybody is responsive to the treatment. ECT works 80% of the time but fails patients suffering from resistant-to-treatment depression 20% of the time along with side effects.


When ECT does not help, patients may feel further distress as they have invested their time, money and hopes in treatment and not received any desired results. Side effects after ECT can include seeing distressing visions or having nightmares, impaired memory, an increase in anxiety levels, and the depression is still there, no change.


ECT takes up much time; patients can take up to anything from 7 to 11 treatments to start seeing some improvement. ECT involves sending an electric current through the brain. The electrical current aims to get to work on the neurotransmitters that are responsible for emotions.


Some patients who have had the ECT treatment comment that the ECT treatment can make their depression worse and feel that it is not worth the time or investment if it fails to work make existing conditions such as anxiety, depression, and cognitive functions worse. The most common side effect is impaired memory of recent events.


ECT may not be suitable for those patients who have existing medical conditions such as cardiovascular illnesses. There is a risk of heart attack or heart interferences for those who have coronary heart disease. ECT was developed in the 1930s, and today there is still some stigma attached to the treatment. ECT, when it works, can take up to six weeks for the patient suffering from depression to see any noticeable effect.


In the past several decades, the focus has been shifted to another neurotransmitter glutamate. It was discovered that Esketamine has the most beneficial rapid results for treating patients who have suffered from major depression, including those patients who are regarded as resistant to treatment for major depression who have had electric shock treatment for their thoughts of suicide and major depression condition.


Esketamine is a faster and efficient acting antidepressant. It is believed to be a significant breakthrough in the treatment for those patients suffering from thoughts of suicide, self-harm, and major depression.


In major depression disorder cases, Esketamine has a significant response rate of 70% and a remission rate of 30% 24 hours after treatment and lasts for up to one week. Esketamine most likely improves the brain’s neural connectivity by boosting the plasticity in several locations in the brain, including the amygdala and hippocampus.


A brand new medication is available now for those patients who are treatment-resistant to other depression treatment. The European Commission has approved an intranasal spray developed by Jansen, a pharmaceutical company, to help end the depression cycle.


Highlights of the Intranasal Spray 

  • High central nervous system penetrance
  • Ease of administration
  • Esketamine contains fast-acting properties
  • Contains anaesthetic, antidepressant, and pain reducing properties
  • Works on the firstor second day upon using the intranasal spray


The new intranasal spray Spravato has many potentials and could potentially save the lives of those patients suffering from thoughts of suicide, self-harm acts, and major depression.


First launched in America and now available in our London clinic. This new nasal spray contains Esketamine, which works on the brain’s neurotransmitters, including glutamate. This new nasal spray Spravato helps to restore the brain’s connections. A safety study carried out monitoring the effects of the Esketamine spray has shown that Spravato can work from as early as the second day after treatment.


If you are sick and tired of feeling depressed and want fast results, please contact us for a free initial consultation.



NCI (2014, August 4) Molecular mechanism identified for activation and desensitisation of prominent neurotransmitter receptor in the brain. Retrieved from https://www.cancer.gov/news-events-/press-releases/2014/glutamatereceptors

Zarate, C Ionescu, D Niciu M (2013, December 8) Glutamate and its receptors in the pathophysiology and treatment of the major depressive disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4048804/#dm139944332535696title

Johnson, C (2019, April 20) A Esketamine  revolution for depression and pain? Spravato, fibromyalgia and ME/CFS. Retrieved from https://www.healthrising.org/blog/2019/04/20/Esketamine -fibromyalgia-spravato-esEsketamine -chronic-fatigue/

Popiolek K, Bejerot S, Brus O, Hammar A, Landen M, Lundberg J, Nordanskog P, Nordenskjoid (2019, July 23) Electroconvulsive therapy in bipolar depression – effectiveness and prognostic factors. Retrieved from https://onlinelibray.wiley.com/doi/full/10.1111/acps.13075

Tracy N, (2014, November 30) Bipolar Depression Treatment - - What to do if ECT Fails. Retrieved from https://www.healthyplace.com/blogs/breakingbipolar/2014/11/bipolar-depression-treatment-what-to-do-if-ect-fails

Purse M, (2020, March 22) How ECT is used for treating depression. Retrieved from https://www.verywellmind.com/ect-for-depression-and-anxiety-379903


Who will I speak to when I call?

Experienced recovery workers who are compassionate, experienced and knowledgeable about substance misuse and mental health issues, they will be happy to take your call and discuss all your queries in a discreet and confidential manner. And if needed they will offer you a free video consultation with a psychiatrist.

How much does treatment cost?

At CRL we endeavour to keep our costs as low as possible whilst at the same time continuing to  provide high quality care. The cost of treatment varies depending on the level of care needed and the length of the treatment plan required. The best way to ascertain this cost would be to speak to one of our experienced recovery workers to determine what treatment plan will be the most effective for you in achieving your desired goals.

Does insurance cover mental health or addictive treatment?

Some private health insurance companies cover the treatment, you will have to check your policy to see if you qualify.

Does insurance cover adult ADHD assessment or treatment?

Yes, most private health insurance companies cover the treatment, you will have to check your policy to see if you qualify.

Do you only treat substance misuse?

No, in addition to our drug and alcohol treatment packages, we also treat a wide range of mental health disorders, some of which may be associated with the individual’s substance misuse and dependency, these include treatment for personality disorders, anxiety, depression, adult ADHD and PTSD amongst other disorders.

What if I need a detox?

We offer a wide range of options for smooth and painless detox thanks to our new provided medications (i.e. long-acting buprenorphine monthly injections). If this is something you are interested in, please call us to discuss which is more suitable for you.

The main emphasis in our detox programs is to provide as much comfort and support while doing our best to minimise any withdrawal symptoms the individual may experience throughout their recovery. Many users recognise they need help and support to get clean but fear the consequences of withdrawals, we have created detox plans to greatly reduce the unpleasant effects of withdrawals.

Do your programs offer aftercare?

Yes, we will continue to support clients after they have completed treatment either by us or elsewhere by offering a wide range of aftercare programs, studies have shown that people have a much better chance of avoiding relapse if they are engaged in aftercare programs. Please get in touch to discuss the best aftercare options for yourself.

Is smoking permitted?

No, this is a medical facility and smoking is not permitted at all.

Do you treat trauma?

Yes, our staff are specially trained in trauma, grief/loss and attachment, we know very well the negative impact these can have on someone’s mental health which can then trigger alcohol/drug misuse and other negative behavioural health challenges. Among our treatment approaches to trauma is EMDR therapy which is very effective in easing and treating PTSD.

What is outpatient care?

utpatient care is less intensive than inpatient care. The patient will usually attend regular meetings with a consultant psychiatrist, counsellor, therapist or key-worker where they will be given similar treatments to those in an inpatient clinic. However, as the patient does not stay overnight, the cost of this care is less expensive.

Outpatient programmes consist of daily, weekly or monthly sessions. Because outpatient treatment requires less time in-attendance, the entire recovery programme generally lasts longer than inpatient care. While inpatient treatment typically lasts for a period of six to eight weeks, an outpatient programme can last many months.

Who is outpatient treatment suitable for?

Outpatient treatment is suitable for individuals who have been struggling with addiction but may benefit from a less intensive approach to recovery than inpatient care.

CRL staff are available to offer helpful advice and information on all types of addiction and the most suitable treatment options. If you would like a referral to a counsellor, therapist or consultant psychiatrist for outpatient treatment, call us today. We can also provide support and advice to the loved ones of those struggling with addiction, as well as information on the treatments we provide and how these can be accessed.

Our staff are compassionate and caring and will treat anything you discuss in the strictest of confidence. If you need advice on addiction, or simply need someone to talk to, please do not hesitate to call us.

Are your staff qualified?

All CRL staff are qualified for their specific roles with many years of experience in working in the addiction and mental health fields. In addition all our staff are always up to date with all their relevant training and registrations.


Our clinical team is happy to answer any questions or concerns that you may have.
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