Approximately 30% of patients treated for major depressive disorder develop treatment-resistant depression (TRD). The STAR*D study demonstrated remission rates decline progressively with each antidepressant failure (37%, 31%, 14%, and 13%, respectively). A single-day individualized dosing regimen of GH001 (synthetic mebufotenin for inhalation) produced rapid, large improvements in depressive...
To compare the efficacy and safety of electroconvulsive therapy (ECT) and ketamine infusion (KET-IFU) in routine care for patients with bipolar I or II depression (BPD). Electronic medical records of patients who received ECT and/or KET-IFU were used to identify patients with BPD who received both ECT and KET-IFU treatments. The change in the 16-item Quick Inventory of Depressive Symptomatology...
Since the last edition of the Black Book, several innovative agents have been approved or are poised to be approved in the coming year. These include novel antidepressants, the first muscarine agonist for the treatment of schizophrenia, the first psychedelic which may be approved for the treatment of PTSD (Post Traumatic Stress Disorder), and the first disease modifying drug for the treatment...
Post-traumatic stress disorder (PTSD) has become one of the most common psychiatric diagnosis in the United States specifically within the veteran population. The current treatment options for this debilitating diagnosis include trauma-focused psychotherapies along with selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI). 1 MDMA has recently...
Objective Hallucinogen-persisting Perception Disorder (HPPD) is a rare condition characterized by the re-experiencing of one or more perceptual symptoms that an individual experienced while intoxicated with a hallucinogenic substance when the individual is sober. While there are several case reports of HPPD in adult patients, there is a scarcity of documented cases in children and adolescents....
We read a recent article published by CNN titled “Ketamine offers lifeline for people with severe depression, suicidal thoughts1” with great interest. The article traces the story of a man with a 35-year history of severe refractory depression, suicidal ideation, and recent suicide attempts who was successfully treated with ketamine as a last resort after failing dozens of other pharmacologic...
Cannabis is a widely used illicit substance that is historically consumed via smoking, but alternative methods of cannabis consumption have been growing in popularity over the past several decades. One such modality is vaporization, which can appeal specifically to adolescent consumers given these pen devices’ ease of concealment, lack of characteristic odor, and marketability. Cannabis...
Introduction and Background Patients with depression who fail to respond to at least two antidepressants in their current episode are considered to have Treatment Resistant Depression (TRD). ECT is an effective treatment of TRD but cognitive side effects limit its use. Ketamine elicits a rapid antidepressant response in sub-anesthetic repeated doses. ECT and ketamine may be modulating the...
Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to...
In this case report, we present a patient with treatment-resistant depression (TRD) and comorbid generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder. Over a 10-year period, our case transitioned from adolescence to adulthood and received antidepressant monotherapy, adjunctive therapy with antipsychotics, lithium, or lamotrigine,...
Hallucinogen-persisting Perception Disorder (HPPD) is a rare condition characterized by the re-experiencing of one or more perceptual symptoms that an individual experienced while intoxicated with a hallucinogenic substance when the individual is sober. While there are several case reports of HPPD in adult patients, there is a scarcity of documented cases in children and adolescents. The...
Since the last edition of the Black Book, several innovative agents have been approved or are poised to be approved in the coming year. These include novel antidepressants, the first muscarine agonist for the treatment of schizophrenia, the first psychedelic which may be approved for the treatment of PTSD (Post Traumatic Stress Disorder), and the first disease modifying drug for the treatment...
Despite the prevalence of Major Depressive Disorder (MDD) and the propensity of affected individuals to eventually die by suicide, there is no therapeutic approved specifically for suicidal ideation and behavior (SI/B) in MDD. The NMDA receptor antagonist ketamine has been investigated for the treatment of depression and shown to have a rapid effect on symptoms. Spravato® (esketamine) is...
Dextromethorphan (DM) may have ketamine-like rapid-acting, treatment-resistant, and conventional antidepressant effects.1,2 This reports our initial experience with DM in unipolar Major Depressive Disorder (MDD). A patient with treatment-resistant MDD (failing adequate trials of citalopram and vortioxetine) with loss of antidepressant response (to fluoxetine and bupropion) twice experienced a...