Psychiatry and Clinical Psychopharmacology
August 11, 2025
Reinhard Janssen-Aguilar, Shakila Meshkat, Huda Al-Shamali et al.
4 citations
Posttraumatic stress disorder (PTSD) is a severe condition that can be difficult to treat, prompting interest in innovative therapies. This systematic review of 94 studies evaluated interventional treatments including neuromodulation, rapid-acting pharmacotherapies like intravenous ketamine and esketamine, and psychedelic-assisted psychotherapies. Randomized controlled trials showed response rates ranging from 12.5% to 80% for transcranial magnetic stimulation, 17% to 67% for intravenous ketamine, and 50% to 87% for MDMA-assisted therapy. Most treatments were well tolerated with only mild, transient adverse effects. The review highlights variability in efficacy, safety, and tolerability across treatments, reflecting differences in patient populations, protocols, and comorbidities. While symptom improvement is observed, sustained efficacy varies, underscoring the need for maintenance strategies.
Psychiatry and Clinical Psychopharmacology
March 30, 2026
Kenji Hashimoto, Feyza Arıcıoğlu, Mesut Çetin
Classical serotonergic psychedelics—psilocybin, DMT, 5-methoxy-DMT, and LSD—can produce rapid and sometimes durable improvements in mood under supervised conditions. The review synthesizes clinical evidence for these compounds in depression and related disorders, noting challenges such as small sample sizes, expectancy effects, and limitations in maintaining blinding. Mechanistic frameworks extend beyond 5-HT2A receptor activity, involving multiple serotonergic subtypes, glutamatergic modulation, synaptic plasticity, and brain network reorganization. Preclinical and clinical evidence points to neurotrophic mechanisms, particularly BDNF-TrkB signaling, as contributors to sustained effects. Acute mystical-type experiences may enhance response but are not strictly required, suggesting plasticity-promoting mechanisms can be partially dissociated from hallucinogenic effects. Peripheral contributions, including gut-brain axis interactions, may influence treatment durability.
Psychiatry and Clinical Psychopharmacology
November 13, 2025
Yu-Chih Shen, Chien-Chen Hung
A 61-year-old woman with treatment-resistant depression, a history of poor response to electroconvulsive therapy, and structural brain damage from a traumatic brain injury received four doses of intranasal esketamine over two weeks. Her depression severity, measured by the Montgomery-Åsberg Depression Rating Scale, improved from severe to mild, suicidal thoughts resolved, anxiety decreased, and nightmares stopped. She experienced only transient dizziness after each dose, with no severe side effects. This single case suggests esketamine may help carefully selected patients with similar complex histories, but larger studies are needed to confirm.
Psychiatry and Clinical Psychopharmacology
August 14, 2025
Nadav Liam Modlin, Jessica L Maples-Keller, Maria Sarang et al.
Among 873 people who reported trauma symptoms or a PTSD/CPTSD diagnosis, 94.8% had experienced psychological trauma and 73.4% had a formal diagnosis. Many had tried multiple medications and psychotherapies but were highly dissatisfied. Significant numbers used marijuana, psychedelics, or MDMA on their own to manage symptoms, with few physical or psychological complications. After learning about MDMA and psilocybin therapies, willingness to try them was high (0.81 and 0.83, respectively). Women and heterosexual individuals showed lower willingness, while younger and more educated respondents were more willing. The findings point to a need for further clinical research and public education about risks and harm reduction.
Psychiatry and Clinical Psychopharmacology
August 11, 2025
Lisa Burback, Olga Winkler, Rakesh Jetly et al.
Half of patients with PTSD do not respond to first-line trauma-focused psychotherapies, which were developed from an anxiety disorder model. This narrative review of therapist-delivered psychotherapies not yet endorsed by clinical guidelines identifies four themes for improving treatment: optimizing existing therapies, adapting psychotherapies used for other conditions, reimagining exposure therapies, and developing new modalities. Emerging approaches include memory reconsolidation-based treatments, combination with pharmacotherapies, neuromodulation, virtual reality, mind-body and somatic psychotherapies, and therapies focused on moral injury, identity, and spirituality. Multi-modal treatments like 3MDR and psychedelic-assisted psychotherapies have multiple synergistic mechanisms. The authors propose a PTSD staging model for empirical evaluation and clinical implementation.