A single intravenous dose of esketamine (0.25 mg/kg) given at the start of surgery reduces postoperative anxiety in adolescents aged 13–18 years, with lower anxiety scores on days 1, 3, 7, and 14 after surgery. Depression scores were lower only on day 14. The drug did not significantly change inflammatory markers (CRP and IL-6) or cause more adverse events than placebo. Esketamine was a protective factor against postoperative anxiety (odds ratio 0.38). The findings suggest a safe, short-term benefit for anxiety, with limited effect on depression, in this age group.
Adding mindfulness-based cognitive therapy (MBCT) to escitalopram hydrobromide improves cognitive function, reduces depression severity, and enhances quality of life more than escitalopram alone in older adults with treatment-resistant depression (TRD). In a randomized trial of 230 older adults with TRD and cognitive impairment, the group receiving MBCT plus escitalopram showed significantly greater gains on the Montreal Cognitive Assessment and General Quality of Life Index-74 at both 6 and 12 weeks, along with greater reductions on the Hamilton Depression Rating Scale, compared to the escitalopram-only group. The combined therapy also yielded higher rates of effective treatment outcomes with fewer ineffective responses.