European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
July 17, 2026
Mauro Scala, Enrico Magrini, Ivana Leccisotti et al.
Suicide remains a leading cause of premature mortality worldwide. Current treatments are limited by delayed onset, durability, or poor tolerability. This narrative review, informed by a structured literature search, summarises the last decade of evidence on pharmacological and neuromodulation interventions for suicidal ideation (SI) or suicide attempt (SA) that are not approved for these...
European Psychiatry
June 23, 2026
Maximilian Preiß, Valentin Popper, Luna Helene Charlotte Faber et al.
An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
International journal of psychiatry in clinical practice
April 29, 2026
David Eckert, Siegfried Kasper
The treatment of treatment-resistant depression (TRD) remains a clinical challenge. Pharmacologically, several augmentation options exist. The aim of this study was to present a mechanistically informed and clinically oriented decision-making framework for the established strategies of lithium, quetiapine, and esketamine. We conducted a narrative, non-systematic review, performing a targeted...
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
January 22, 2026
David Eckert, Siegfried Kasper
Treatment-resistant depression (TRD) poses a major challenge in research and clinical practice. Various guidelines recommend different pharmacological approaches. While lithium and second-generation antipsychotics have traditionally been the drugs of choice in cases of medication resistance, recent years have seen increasing evidence for the efficacy of esketamine as a fast-acting agent against...
The International Journal of Neuropsychopharmacology
August 1, 2025
Siegfried Kasper
Abstract Background Psycholicibin is now studied in clinical settings. Aims & Objectives To elaborate if side effects are part of the therapeutic process. Method Literature overview and personal statement. Results The recent development of the socalled “psychedelics” reminds us that unfortunately some medications which we used in psychiatry have a large burden of side effects, like the...
medRxiv Preprint Server
March 21, 2025
Leo R. Silberbauer, Benjamin Eggerstorfer, Paul Michenthaler et al.
1 citation
preprint
Background Ketamine represents a significant advancement in antidepressant therapy, but the commonly used intravenous and intranasal application routes currently limit its availability beyond specialized centers. By contrast, oral ketamine treatment might constitute an alternative that is easy to administer with established safety and efficacy for patients with chronic and severe pain at home.
Wiener klinische Wochenschrift
March 1, 2025
Pia Baldinger-Melich, Marie Spies, Ina Bozic et al.
5 citations
Modern electroconvulsive therapy (ECT) and the approval of nasal esketamine for clinical use have significantly improved the approach to treatment-resistant depression (TRD), which is defined as non-response to at least two different courses of antidepressants with verified adherence to treatment, adequate dosage, and duration of treatment. The goal of this literature review is to present the...
International journal of psychiatry in clinical practice
2024
Marie Spies, Siegfried Kasper, Richard Frey et al.
Modern electroconvulsive therapy (ECT) and ketamine currently represent the most effective treatment options in depressed patients showing non-response to two or more trials of antidepressants. Recently, large sample head-to-head comparisons of intravenous ketamine versus ECT for treatment-resistant depression (TRD) have fuelled the debate on which therapy might be more effective. However, the...
Frontiers in Psychiatry
November 23, 2023
Florian Buchmayer, Siegfried Kasper
19 citations
Intranasal esketamine for treatment-resistant depression has been introduced and approved by the FDA and EMA in 2019 and 2020, respectively. Since then, the administration practices were found different among countries. Major depression has a high impact on many humans lives worldwide and more than a third of treated people are not responding after several treatment attempts. Additional...
World Psychiatry
September 15, 2023
Roger S McIntyre, Mohammad Alsuwaidan, Bernhard T Baune et al.
712 citations
Treatment‐resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision‐making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a...
American Journal of Psychiatry
March 17, 2021
Roger S McIntyre, Joshua D. Rosenblat, Charles B. Nemeroff et al.
694 citations
Replicated international studies have underscored the human and societal costs associated with major depressive disorder. Despite the proven efficacy of monoamine-based antidepressants in major depression, the majority of treated individuals fail to achieve full syndromal and functional recovery with the index and subsequent pharmacological treatments. Ketamine and esketamine represent...
The World Journal of Biological Psychiatry
November 3, 2020
Siegfried Kasper, Wiesław Jerzy Cubała, Andrea Fagiolini et al.
84 citations
OBJECTIVES: -methyl-d-aspartate (NMDA) glutamate receptor antagonist, is a novel, fast-acting option in this patient population. This manuscript provides expert guidance on the practicalities of using esketamine nasal spray. METHODS: A group of six European experts in major depressive disorder (MDD) and TRD, with clinical experience of treating patients with esketamine nasal spray, first...
The International Journal of Neuropsychopharmacology
August 26, 2020
Dawn F. Ionescu, Dong-Jing Fu, Xin Qiu et al.
411 citations
BACKGROUND: Patients with major depressive disorder (MDD) having active suicidal ideation with intent require immediate treatment. METHODS: This double-blind study (ASPIRE II) randomized adults (aged 18-64 years) with MDD having active suicidal ideation with intent to esketamine 84 mg or placebo nasal spray twice weekly for 4 weeks, given with comprehensive standard of care (hospitalization ≥5...
The Journal of Clinical Psychiatry
April 20, 2020
Ewa Wajs, Leah Aluisio, Richard Holder et al.
288 citations
OBJECTIVE: To evaluate long-term safety and efficacy of esketamine nasal spray plus a new oral antidepressant (OAD) in patients with treatment-resistant depression (TRD). METHODS: This phase 3, open-label, multicenter, long-term (up to 1 year) study was conducted between October 2015 and October 2017. Patients (≥ 18 years) with TRD (DSM-5 diagnosis of major depressive disorder and nonresponse...
Cerebral Cortex
September 6, 2018
Gregory M. James, Gregor Gryglewski, Thomas Vanicek et al.
16 citations
Parcellation of distinct areas in the cerebral cortex has a long history in neuroscience and is of great value for the study of brain function, specialization, and alterations in neuropsychiatric disorders. Analysis of cytoarchitectonical features has revealed their close association with molecular profiles based on protein density. This provides a rationale for the use of in vivo molecular...
European Psychiatry
April 1, 2017
Lucie Bartova, A. Weidenauer, M. Dold et al.
IntroductionTreatment resistant depression (TRD) affecting approximately 10–30% of all depressed patients often remains misdiagnosed and undertreated, leading to a higher risk of relapse and suicide. Electroconvulsive therapy (ECT) and sub-anesthetic ketamine have repeatedly shown to be effective in the TRD population. Administering ketamine as an anesthetic component to augment antidepressant...