Molecular Psychiatry
September 1, 2024
Sanne Y Smith-Apeldoorn, Jolien K E Veraart, Jeanine Kamphuis et al.
23 citations
A randomized placebo-controlled trial tested whether a fixed low dose of oral esketamine (30 mg three times daily) could reduce depression severity in patients with treatment-resistant depression. Over six weeks, the drug showed no benefit compared to placebo on the Hamilton Depression Rating Scale. Dizziness and sleep hallucinations were more common with esketamine. In an open-label extension phase where doses were individually titrated up to 3.0 mg/kg twice weekly, depressive symptoms decreased substantially. The findings suggest that fixed low-dose oral esketamine is ineffective, but individually adjusted higher doses may hold promise for treatment-resistant depression.
Psychiatry Research
March 1, 2025
Juliana Lima Constantino, Martijn Godschalk, Jens H van Dalfsen et al.
14 citations
About half of people with treatment-resistant depression do not respond to (es)ketamine, despite its known efficacy. This systematic review of 44 studies examined whether demographic or clinical traits predict who will respond or remit after (es)ketamine treatment. Overall, most demographic and clinical variables showed no consistent predictive value. Preliminary evidence linked better response to anhedonia, sleep disturbances, childhood physical abuse, obesity, openness, better episodic memory and visual learning, poorer neurocognitive performance, slower processing speed, and lower attention, while melancholic depression, benzodiazepine use, and metabolic syndrome were linked to worse response. These associations need replication, but suggest (es)ketamine may benefit patients with characteristics often considered hard to treat.
Depression and Anxiety
January 1, 2024
Jelle Lubbers, Dirk E. M. Geurts, Philip Spinhoven et al.
10 citations
Mindfulness-based cognitive therapy (MBCT) added to treatment as usual reduced depressive symptoms and overall functional impairment more than treatment as usual alone in patients with persistent or recurrent major depressive disorder, with medium and small effect sizes respectively. The therapy worked better for those who started with higher levels of rumination and perseverative thinking and lower levels of self-compassion; these traits moderated the treatment's effects. No mediators of MBCT's effects were identified, as the therapy did not change the assessed potential mediators by mid-treatment. Allocating MBCT based on patients' rumination and self-compassion levels could make symptom reduction more efficient.
Journal of psychopharmacology (Oxford, England)
April 25, 2025
Jolien Ke Veraart, Sanne Y Smith-Apeldoorn, Annemarie van der Meij et al.
6 citations
Oral esketamine, taken twice weekly for six weeks at doses from 0.5 to 3 mg/kg, reduced depressive symptom severity in adults with severe treatment-resistant depression who had not benefited from an average of 8.1 prior antidepressant trials and, in 63% of cases, electroconvulsive therapy. Hamilton Depression Rating Scale scores dropped from 21.2 to 15.8. Nearly half of participants achieved a clinically meaningful improvement, 26.8% responded, and 15.6% remitted. Side effects were common but well tolerated, with a 7.6% dropout rate and no significant urinary or cognitive adverse effects. Treatment continued beyond six weeks in 45.9% of participants to maintain gains.
Trials
May 13, 2025
Ka Yan, Nessa Ikani, Cleoputri Yusainy et al.
1 citation
Elevated stress, anxiety, and depression are common among Indonesian undergraduates, but access to mental healthcare is difficult and costly, and many avoid professional help. This randomized controlled trial tests whether a 14-day online mindfulness intervention reduces stress, anxiety, depressive symptoms, and repetitive negative thinking (RNT) compared to psychoeducation and waitlist controls. The study also examines whether changes in RNT explain mindfulness's effects on these outcomes. Measures are taken at baseline, post-intervention, and at a 3-month follow-up. The trial aims to provide evidence that a brief, accessible online mindfulness program could be a low-threshold strategy for improving mental health in Indonesia.
Mindfulness
July 1, 2024
Jelle Lubbers, Philip Spinhoven, Mira B. Cladder-Micus et al.
After Mindfulness-Based Cognitive Therapy (MBCT), many patients with major depressive disorder shift toward healthier mindfulness profiles, and those who change profiles show greater improvement in mental health than those who do not. Among 500 patients, four mindfulness profiles were identified: Very low mindfulness, Non-judgmentally aware, Judgmentally observing, and High mindfulness. Of 168 patients initially in the Very low mindfulness profile, 71 moved to Non-judgmentally aware and 30 to High mindfulness. Of 129 in Non-judgmentally aware, 49 moved to High mindfulness; of 141 in Judgmentally observing, 37 moved to High mindfulness. All 61 patients already in High mindfulness remained there. Profile change was linked to above-average improvement in depressive symptoms, functional impairment, worry, and self-compassion, while no change (except staying in High mindfulness) was linked to below-average improvement.
Mindfulness
February 1, 2024
Jelle Lubbers, Philip Spinhoven, Mira B. Cladder-Micus et al.
In patients with current or remitted major depressive disorder, four distinct mindfulness profiles were identified using latent profile analysis on questionnaire data from 754 individuals. Three profiles matched those found in previous depressed samples (very low mindfulness, high mindfulness, non-judgmentally aware), and one matched a profile from non-clinical populations (judgmentally observing). Those with high mindfulness had the best mental health—fewer depressive symptoms, less worry, less functional impairment, and more self-compassion—while those with very low mindfulness had the worst. However, mindfulness profiles did not predict how much mental health changed after Mindfulness-Based Cognitive Therapy, suggesting profiles are linked to current mental health but not to treatment response.
PLoS One
January 1, 2023
Marloes J Huijbers, Carolien Wentink, Peter L B J Lucassen et al.
Adding Mindfulness-Based Cognitive Therapy (MBCT) to supported protocolized discontinuation (SPD) did not significantly help patients stop antidepressant medication (ADM) more than SPD alone. In a cluster-randomized trial across 36 Dutch primary care practices, 44% of patients offered MBCT plus SPD discontinued ADM within six months, compared to 33% offered SPD alone—a difference that was not statistically significant. Only 27% of those assigned to MBCT completed the program. Participation was low overall: of about 3000 invited patients, 119 started the interventions and 92 completed all assessments. No serious adverse events occurred.