Combining esketamine with the monoamine oxidase inhibitor tranylcypromine in patients with treatment-resistant depression does not cause clinically dangerous blood pressure spikes, despite earlier safety concerns. In a retrospective analysis of 509 esketamine administrations in 43 hospitalized patients, those who also received tranylcypromine showed statistically greater changes in systolic and diastolic blood pressure during the first hour after esketamine administration, but these changes were small (mean systolic increase of 2.96 mmHg versus a decrease of 8.84 mmHg in the non-tranylcypromine group) and not clinically significant. Heart rate was unaffected. A dose-response relationship was observed, with higher tranylcypromine doses linked to larger blood pressure increases, suggesting caution with high doses. The findings indicate that the combination is safe at standard doses.
Ketamine, a rapid-acting treatment for depression and other psychiatric conditions, has raised safety concerns because chronic recreational use can damage the bladder and urinary tract. This systematic review of 27 clinical studies, mostly in people with depression, found that 0% to 24.5% of patients receiving ketamine reported urological symptoms, which were usually mild or moderate. Objective measures of bladder and kidney function showed no significant changes from before to after treatment. The evidence suggests that therapeutic ketamine does not appear to increase the risk of urological problems, but most studies were short-term and did not systematically monitor symptoms, so more long-term research is needed.
A single day of treatment with an inhaled synthetic formulation of mebufotenin (GH001) significantly reduced depression symptoms in adults with treatment-resistant depression compared to placebo. In a randomized, double-blind trial of 81 patients, those receiving up to three escalating doses of GH001 showed an average 15.5-point greater improvement on the Montgomery-Åsberg Depression Rating Scale by day 8 than those on placebo. Remission rates were 57.5% for GH001 and 0% for placebo. No severe or serious adverse events occurred. The findings suggest GH001 may be a rapid-acting, well-tolerated treatment option for treatment-resistant depression.
Adding mantra meditation to usual inpatient care for major depression led to greater reductions in clinician-rated depression severity than adding progressive muscle relaxation. At 3-month follow-up, the mantra meditation group scored about 4.8 points lower on the MADRS depression scale, and at 6-month follow-up about 6.2 points lower, both differences favoring mantra meditation. Self-reported depression did not differ significantly between groups after treatment. The benefit appeared mainly in mood rather than cognitive symptoms. The study involved 123 inpatients at a psychiatric hospital who were diagnosed with major depression.