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.
CNS Neuroscience & Therapeutics
April 2, 2011
Thilo Deckersbach, Britta K. Hölzel, Lori Eisner et al.
130 citations
A mindfulness-based cognitive therapy (MBCT) program tailored for bipolar disorder was tested in 12 individuals. After 12 group sessions and at a 3-month follow-up, participants showed increased mindfulness, reduced residual depressive mood symptoms, fewer attentional difficulties, and improvements in emotion regulation, psychological well-being, positive affect, and psychosocial functioning. The findings suggest MBCT may help manage residual mood symptoms and improve overall functioning in people with bipolar disorder.
Journal of Psychiatric Practice
November 1, 2011
Jonathan P. Stange, Lori Eisner, Britta K. Hölzel et al.
83 citations
People with bipolar disorder often experience cognitive difficulties such as problems with executive functioning, even when their mood is stable. In an open pilot trial of mindfulness-based cognitive therapy (MBCT), participants reported significant improvements in executive functioning, memory, and the ability to start and complete tasks, as measured by the Behavior Rating Inventory of Executive Function and the Frontal Systems Behavior Scale. These cognitive improvements were linked to increases in mindful, nonjudgmental awareness of thoughts and feelings, but not to reductions in depression. Gains tended to fade after treatment ended, though some improvements in executive functioning persisted for three months. MBCT may serve as an adjunct to medication for improving cognition in bipolar disorder.
JAMA
May 24, 2019
Ole Köhler‐forsberg, Cristina Cusin, Andrew A. Nierenberg
18 citations
Recent evidence shows that several nonpharmacological and drug therapies can benefit people with major depressive disorder. Effective options include exercise, a Mediterranean diet with structured dietary support, ketamine and esketamine, anti-inflammatory drugs, brexanolone, and psilocybin.
Psychiatry research communications
September 1, 2024
Alexandra K Gold, Dustin J Rabideau, Daniel Nolte et al.
2 citations
People with more severe anxiety, depression, or social difficulties initially improved in well-being during low-intensity mindfulness interventions (three or eight sessions), but those with worse symptoms tended not to sustain improvements and rebounded toward baseline during follow-up. The findings suggest that such brief mindfulness-based treatments can still be clinically useful for individuals with more severe mental health symptoms, as they experienced initial improvement, but offering longer-duration treatment might prevent symptom rebounding.
JAMA Psychiatry
July 1, 2026
Sung Ryul Shim, Hye Su Jeong, Tanner J. Bommersbach et al.
1 citation
A systematic review and meta-analysis of 26 randomized clinical trials with 1,166 patients experiencing a major depressive episode found that intravenous ketamine infusions significantly reduce suicidal and depressive symptoms in the acute phase. A single ketamine infusion lowered suicidal symptoms at 24 hours and at 1 month, and repeated infusions produced similar reductions. Depressive symptoms decreased significantly from 4 hours through 1 week after a single infusion and after repeated infusions. Serious adverse events were unrelated to the interventions, and other side effects were transient. Longer-term outcomes remain unclear.