World Psychiatry
September 15, 2023
Roger S McIntyre, Mohammad Alsuwaidan, Bernhard T Baune et al.
712 citations
At least 30% of people with depression meet the common definition of treatment-resistant depression (TRD): inadequate response to two or more antidepressants despite adequate trials and adherence. Many cases are actually pseudo-resistant due to insufficient treatment or non-adherence. No consensus definition with proven predictive utility for clinical decisions exists, leading to varied prevalence estimates and inconsistent care. Intravenous ketamine and intranasal esketamine are effective for TRD. Some second-generation antipsychotics (e.g., aripiprazole, quetiapine XR) help as adjuncts in partial responders, but only the olanzapine-fluoxetine combination has been studied in FDA-defined TRD. Repetitive transcranial magnetic stimulation and electroconvulsive therapy are established effective interventions. Evidence for extending trials, switching, or combining antidepressants is mixed, and manual-based psychotherapies are not effective alone but help when added to antidepressants.
Frontiers in Integrative Neuroscience
July 8, 2020
June van Aalst, Jenny Ceccarini, Koen Demyttenaere et al.
57 citations
A review of 34 neuroimaging studies of yoga practitioners finds consistent increases in gray matter volume in the insula and hippocampus, increased activation in prefrontal cortical regions, and functional connectivity changes mainly within the default mode network. Variability in findings partially reflects different yoga styles and sample size limitations. Direct comparator groups such as physical activity are rarely used. The authors discuss hypotheses on the underlying neurobiology of yoga's potential beneficial effects.
EJNMMI Research
May 14, 2020
June van Aalst, Jenny Ceccarini, Georg Schramm et al.
13 citations
Experienced yoga practitioners show long-term decreases in glucose metabolism in the medial temporal cortex, striatum, and brainstem compared to yoga-naive controls, with greater decreases linked to more years of regular practice. A single yoga practice increased metabolism in the cerebellum. No differences were found in brain structure or resting-state connectivity. The findings suggest that regular yoga practice may induce lasting metabolic changes in brain regions involved in memory, emotion, and motor control, but a prospective study is needed to confirm causality.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
April 1, 2025
Eduard Vieta, Nahida Ahmed, Celso Arango et al.
12 citations
Patients with treatment-resistant depression who received esketamine nasal spray experienced 43.2% more weeks with functional remission over 32 weeks compared to those taking quetiapine extended release, a difference of 2.0 weeks. Esketamine also led to an 11.9% reduction in productivity loss due to absenteeism and a 14.2% reduction in overall work productivity loss. Both treatments were taken alongside an ongoing SSRI or SNRI. The findings suggest that esketamine provides greater improvements in daily functioning and workplace productivity for this patient group.
Frontiers in Psychiatry
October 18, 2021
June van Aalst, Lise Jennen, Koen Demyttenaere et al.
9 citations
A 12-week yoga intervention, compared with indoor cycling, improved interoceptive awareness and perceived cognitive function in healthy female beginners. Thirty healthy women (average age 28.4 years) were randomly assigned to yoga or cycling. Yoga participants reported higher interoceptive awareness and better cognitive functioning than the cycling group. No significant differences in glucose metabolism, synaptic density, or gray matter volume were detected between groups. The cycling group showed increased relative glucose metabolism in the parahippocampal/fusiform gyrus and cerebellum. The authors suggest that longer or more frequent yoga practice may be needed to detect cerebral metabolic or morphologic changes at the macroscopic level.