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Mauro Pettorruso

University of Chieti-Pescara, Bassano Bresciano Astronomical Observatory

35 papers in the library · 834 citations · publishing 2018-2026

Papers

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Treatment and management approaches for ketamine misuse: A systematic review of medical interventions

Journal of Substance Use and Addiction Treatment July 1, 2026 Alessio Mosca, Stefania Chiappini, Andrea Miuli et al.

INTRODUCTION: Ketamine, initially developed as an anesthetic and now increasingly prescribed for treatment-resistant depression, is also widely misused in recreational contexts. Chronic ketamine use, often leading to dependence, has been associated with severe physical complications, including ulcerative cystitis and gastrointestinal dysfunction, as well as cognitive, affective, and psychotic...

Sex- and Age-Stratified Differences in Antidepressant Response to Intranasal Esketamine in Treatment-Resistant Depression: A Secondary Analysis of the REAL-ESK Study

Clinical Neuropsychopharmacology and Addiction June 25, 2026 Luca Persico, Giacomo D’andrea, Clara Cavallotto et al.

Background: Intranasal esketamine (ESK-NS) is an effective treatment for treatment-resistant depression (TRD), but whether antidepressant outcomes differ by sex and age remains insufficiently explored. Methods: This secondary analysis of the REAL-ESK study included 210 patients with TRD treated with ESK-NS in routine clinical practice and assessed at baseline (T0), one month (T1), and three...

Mechanistic insights toward dissociating therapeutic from psychedelic effects: bridging the gap between psychedelic research and mental health care

Translational Psychiatry June 24, 2026 Mauro Pettorruso, Giacomo D’andrea, Antonio Inserra et al.

Clinical trials investigating psychedelic compounds for depression and anxiety-related disorders are yielding promising preliminary results. Psychedelics produce profound alterations in brain function—such as suppression of the default mode network and thalamocortical dysregulation—leading to intense subjective experiences including ego dissolution and mystical-type states. While often...

Epigenetic Mechanisms of Psychedelics in Addiction: Emerging Evidence and Therapeutic Potential

Clinical Neuropsychopharmacology and Addiction April 17, 2026 Antonio Inserra, Francesca Zoratto, Mauro Pettorruso et al.

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Neuroimaging insights from Wistar-Kyoto rats under chronic mild stress: morphological and metabolic brain correlates of treatment-resistant depression.

Scientific Reports March 27, 2026 Gianmauro Palombelli, Valentina Zecca, Marta Boffa et al. 1 citation

Major depressive disorder is highly prevalent and disabling, and many patients do not respond to standard therapies, resulting in treatment-resistant depression (TRD). Progress in TRD requires preclinical models with poor response to conventional treatments. The Wistar-Kyoto rat exposed to chronic mild stress (WKY/CMS) offers a robust paradigm: it shows limited responsiveness to standard...

Anomalous self-experience in substance-induced and primary psychotic disorders: a cross-sectional comparative study using the EASE interview.

Annals of General Psychiatry November 25, 2025 Luisa de Risio, Alessio Mosca, Arianna Pasino et al.

Disturbances of the minimal self, or anomalous self-experiences (ASEs), are increasingly regarded as a core feature of primary psychotic disorders (PPDs). However, it remains unclear whether similar self-disorders are present in substance-induced psychosis (SIP), a condition that often mimics PPDs in its early stages. The study aims to compare ASEs between PPD and SIP using the EASE interview,...

Psychedelics and ketamine/esketamine in depressive disorders: biological mechanisms and associated neuroimaging and clinical changes.

Transl Psychiatry October 31, 2025 Giacomo D’andrea, Stefania Chiappini, Laura Ciavoni et al. 3 citations

Psychedelics and ketamine/esketamine in depressive disorders: biological mechanisms and associated neuroimaging and clinical changes.

Novel psychoactive substances (NPS) as a risk factor for psychosis: A systematic review of the literature

Neuroscience & Biobehavioral Reviews October 19, 2025 Alessio Mosca, Gianluca Mancusi, Stefania Chiappini et al. 6 citations

Novel psychoactive substances (NPS) are increasingly used by young individuals for their psychoactive effects and have been frequently associated with the emergence of psychotic symptoms and schizophrenia spectrum disorders. However, it remains unclear whether NPS use directly increases the risk of psychosis onset or whether individuals with a predisposition to psychosis are more likely to...

Novel perspectives for glutamatergic strategies, psychedelics and antipsychotic augmentation in Treatment Resistant Depression: A narrative review

Clinical Neuropsychopharmacology and Addiction September 25, 2025 Stefania Chiappini, Clara Cavallotto, Andrea Miuli et al. 2 citations

Introduction: Treatment-Resistant Depression (TRD) affects approximately 30–50% of patients with Major Depressive Disorder (MDD) who fail to respond to at least two adequate antidepressant trials. This condition presents substantial clinical and functional challenges, and no universally accepted treatment algorithm currently exists. Emerging therapeutic strategies, particularly glutamatergic...

Endocannabinoids, depression, and treatment resistance: Perspectives on effective therapeutic interventions

Psychiatry Research August 18, 2025 Ilenia Rosa, L. Padula, Francesco Semeraro et al. 2 citations

Depression is a prevalent and heterogeneous disorder with significant personal and social consequences. The rise of treatment-resistant depression (TRD) challenges traditional approaches and underscores the need for a broader neurobiological perspective. When monoaminergic modulation proves insufficient, clinical guidelines increasingly turn to non-monoaminergic interventions such as...

631. PSILOCYBIN AND KETANSERIN VS RTMS IN TREATMENT-RESISTANT DEPRESSION: ENHANCING TOLERABILITY BY MITIGATING PSYCHEDELIC EFFECTS

The International Journal of Neuropsychopharmacology August 1, 2025 Giovanni Martinotti, Clara Cavallotto, Giacomo D’andrea et al.

Abstract Background Among the innovative treatments investigated for depression, psilocybin appears to play an extremely promising role, with several studies showing remission rates up to 70% in patients with treatment-resistant depression (TRD) treated with protocols involving a single or double dose administration [1,2]. Psilocybin is a psychedelic compound belonging to the tryptamine class,...

Effectiveness of repeated Esketamine nasal spray administration on anhedonic symptoms in treatment-resistant bipolar and unipolar depression: A secondary analysis from the REAL-ESK study group.

Psychiatry Research July 26, 2025 Giacomo D’andrea, Clara Cavallotto, Mauro Pettorruso et al. 16 citations

INTRODUCTION Anhedonia, defined as the diminished ability to experience or anticipate pleasure, is a core symptom of major depressive disorder (MDD) and bipolar depression (BD), and associated with depression severity, suicidality and poor treatment outcomes. Conventional antidepressants demonstrate limited efficacy against anhedonia. Esketamine nasal spray (ESK-NS) - a novel NMDA receptor...

Alexithymia and psychopathological dimensions in First-Episode Psychosis: Comparative patterns in natural cannabis versus synthetic cannabinoid users

Journal of Psychiatric Research June 19, 2025 Valerio Ricci, Ilenia di Muzio, Mancusi Gianluca et al. 2 citations

AIMS: This study aimed to investigate the differences in psychotic symptomatology, dissociative symptoms, alexithymia, and aberrant salience among three groups: non-cannabis users (NU), natural cannabis users (NC), and synthetic cannabinoid users (SCs). The study also explored the patterns of alexithymia and its associations with other psychopathological dimensions in these populations....

Patient Experience with Intranasal Esketamine in Treatment-Resistant Depression: Insights from a Multicentric Italian Study (REAL-ESKperience)

Journal of Personalized Medicine April 1, 2025 Marco Di, M. Pepe, Giacomo D’andrea et al. 18 citations

Background. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients’ perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients,...

Emerging strategies and clinical recommendations for the management of novel depression subtypes.

Expert Review of Neurotherapeutics April 1, 2025 Stefania Chiappini, Gaia Sampogna, Antonio Ventriglio et al. 17 citations

The phenomenology of depression is characterized by a wide array of emotional, cognitive, and physical symptoms that significantly disrupt an individual's life. Societal changes, driven by technological advancements, economic pressures, environmental concerns including climate change, and shifting cultural norms, have influenced how depression manifests and is understood. These developments...

Over-the-counter Psychosis: A Systematic Review of the Misuse of Antihistamines, Cough Medicines, and Decongestants and the Risk of Developing Psychosis

Current Neuropharmacology February 20, 2025 Alessio Mosca, Stefania Chiappini, Gianluca Mancusi et al. 3 citations

BACKGROUND: The widespread availability and accessibility of over-the-counter (OTC) medicines play a vital role in modern healthcare systems, enabling individuals to manage minor health concerns independently. However, certain OTC medications possess pharmacological properties that render them susceptible to misuse and abuse, including stimulants, laxatives, sedatives, and opiate-containing...

EXPLORING VORTIOXETINE COMBINATION WITH INTRANASAL ESKETAMINE: A PROMISING ALTERNATIVE TO SSRI/SNRI - INSIGHTS FROM THE REAL-ESK STUDY

The International Journal of Neuropsychopharmacology February 1, 2025 Clara Cavallotto, Giacomo D’andrea, Andrea Miuli et al. 1 citation

Abstract Background Treatment-Resistant Depression (TRD) affects almost 30% of patients with Major Depressive Disorder (MDD) (1). Esketamine Nasal Spray (ESK-NS) has recently been approved for TRD in combination with a Serotonin Specific Reuptake Inhibitor/SSRI or a Serotonin-Norepinephrine Reuptake Inhibitor/SNRI. There is a lack of studies investigating the effectiveness and safety of ESK-NS...

Esketamine Treatment Trajectory of Patients with Treatment-Resistant Depression in the Mid and Long-Term Run: Data from REAL-ESK Study Group.

Current Neuropharmacology 2025 Gianluca Rosso, Giacomo d'Andrea, Stefano Barlati et al. 23 citations

Data on long-term treatment with Esketamine Nasal Spray (ESKNS) in real-world patients with treatment resistant depression (TRD) is scarce. The primary aim of the study is to evaluate the effectiveness and tolerability of ESK-NS treatment at 6 and 12-month follow-ups. This is part of an observational, retrospective, multicentric Italian study (REAL-ESK study). Subjects for the present study...

Exploring vortioxetine combination with intranasal esketamine: A feasible alternative to SSRI/SNRI? - Insights from the REAL-ESK study.

Journal of Affective Disorders December 15, 2024 Giacomo d'Andrea, Andrea Miuli, Mauro Pettorruso et al. 6 citations

Treatment-Resistant Depression (TRD) affects almost 30 % of patients with Major Depressive Disorder (MDD). Esketamine Nasal Spray (ESK-NS) has recently been approved for TRD in combination with a Serotonin Specific Reuptake Inhibitor/SSRI or a Serotonin-Norepinephrine Reuptake Inhibitor/SNRI. There is a lack of studies investigating the effectiveness and safety of ESK-NS in combination with...

Piperazine Abuse and Psychosis: A Systematic Review of the Literature

Psychiatry International September 20, 2024 Alessio Mosca, Stefania Chiappini, Andrea Miuli et al. 5 citations

Background: Piperazines, synthetic compounds known for their stimulant and hallucinogenic effects, have gained prominence among novel psychoactive substances (NPS) and are frequently associated with adverse psychiatric outcomes, including psychosis. Methods: A systematic review of the literature available up to 23 May 2024 was conducted, using the PubMed, Scopus, and Web of Science databases,...

Aberrant salience in cannabis-induced psychosis: a comparative study

Frontiers in Psychiatry January 8, 2024 Valerio Ricci, Ilenia di Muzio, F. Ceci et al.

Background Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the...

Intranasal esketamine as tool for rapid cycling bipolar disorder: A case report of successful mood stabilization

Psychiatry Research Case Reports October 18, 2023 Giacomo D’andrea, Ornella di Marco, Francesco Maria Semeraro et al. 1 citation

Rapid Cyclic Bipolar Disorder (RCBD) is a debilitating condition that manifests as four or more episodes of depression, mania, or hypomania in a span of one year, with depression being the predominant event. RCBD is prevalent among individuals diagnosed with bipolar disorder and is associated with elevated suicide risk, prolonged disease duration, unfavorable clinical outcomes, and cognitive...

Exploring the potential of a bridge therapy: Synergistic approach integrating intravenous ketamine and intranasal esketamine for treatment‐resistant depression

Acta Psychiatrica Scandinavica September 8, 2023 Giacomo D’andrea, Mauro Pettorruso, T. Rhee et al. 8 citations

Depressive disorders represent a significant economic and health burden globally. This is particularly evident in treatment-resistant depression (TRD), commonly defined as the absence of a satisfactory response to at least two different antidepressant trials (as defined by the U.S. Food and Drug Administration/FDA and European Medicine Agencies/EMA). The foregoing TRD cases frequently manifest...

Predicting outcome with Intranasal Esketamine treatment: A machine-learning, three-month study in Treatment-Resistant Depression (ESK-LEARNING)

Psychiatry Research July 29, 2023 Mauro Pettorruso, Roberto Guidotti, Giacomo D’andrea et al. 56 citations

Treatment-resistant depression (TRD) represents a severe clinical condition with high social and economic costs. Esketamine Nasal Spray (ESK-NS) has recently been approved for TRD by EMA and FDA, but data about predictors of response are still lacking. Thus, a tool that can predict the individual patients' probability of response to ESK-NS is needed. This study investigates sociodemographic and...