Current Medical Research and Opinion
February 1, 2024
Dakota Sicignano, Adrían V. Hernández, Benjamin Schiff et al.
19 citations
A meta-analysis of randomized controlled trials found that psychedelics, including LSD, increased the odds of patients with alcohol use disorder achieving abstinence or substantially reducing drinking compared to placebo. In double-blind, placebo-controlled trials, LSD (3 trials) produced an odds ratio of 1.99, and any psychedelic (4 trials) produced an odds ratio of 2.16. When including less rigorous controlled trials, the positive effect persisted. However, four of six trials had a high risk of bias and other methodological issues. One trial reported suicidal ideation and transient blood pressure increases, highlighting unresolved safety concerns. The evidence is promising but too weak for definitive conclusions; more rigorous trials are needed.
Current Medical Research and Opinion
June 17, 2024
Francisco J Appiani, Stanley N. Caroff
5 citations
Interest in psilocybin as a treatment for depression, especially treatment-resistant depression, has grown, but phase 2 studies have been inconclusive. Issues like maintaining double-blinding and the role of adjunctive psychotherapy introduce biases that complicate clear results. Historical patterns with psychoactive substances show an initial excess of optimism followed by addictive behaviors and public health risks. The efficacy and safety of psilocybin treatment have not been unequivocally established. Excessive optimism among researchers may lead to widespread adoption without sufficient evidence. A cautious, measured approach is needed to balance innovation and prudence in advancing depression treatments.
Current Medical Research and Opinion
September 1, 2024
Lisa Harding, Maryia Zhdanava, Aditi Shah et al.
2 citations
Among US adults with treatment-resistant depression who initiated esketamine nasal spray, those whose health plans had prior authorization criteria stricter than the drug label (stringent cohort, 168 patients) and those with less or equally strict criteria (non-stringent cohort, 400 patients) had similar treatment histories. Both groups completed about four antidepressant treatment courses on average before starting esketamine, and roughly 95% used augmentation therapy, with about 59% using an antipsychotic. These averages exceeded the number of antidepressant trials mandated by the esketamine label, suggesting that requiring additional prior authorization steps beyond the label may not be necessary.
Current Medical Research and Opinion
August 23, 2024
Jadwiga Najib
1 citation
Psilocybin combined with psychotherapy shows promise for treating depressive disorders, including major depressive disorder and treatment-resistant depression. Controlled and uncontrolled clinical trials report immediate and sustained antidepressant and anxiolytic effects, with benefits lasting up to 12 months post-treatment. Psilocybin has a favorable safety profile, is well-tolerated, and has low abuse potential. It may offer a valuable option for patients with depression, including those with comorbid terminal cancer. Future research is needed to confirm these findings and explore the synergistic interaction between psilocybin and psychological support.
Current Medical Research and Opinion
July 15, 2026
Anita H. Clayton, Gus Alva, Phillip Bowman et al.
A panel of 10 clinicians with experience treating major depressive disorder (MDD) used a modified Delphi process to develop 27 consensus recommendations for starting the medication dextromethorphan-bupropion extended release (45 mg/105 mg). The recommendations, which achieved a mean overall agreement score of 3.8, include using the drug as a first-line treatment for MDD, including when anxiety symptoms are present; individualizing treatment based on safety information in the Prescribing Information; using it for patients who had inadequate response, residual symptoms, or intolerable side effects from prior treatments; considering drug interactions when switching or adding medications; and switching cautiously from ketamine or esketamine due to their short-to-intermediate elimination half-lives. These recommendations offer practical guidance for initiating this treatment.
Current Medical Research and Opinion
February 1, 2025
Manish K. Jha, Amanda Teeple, Jason Shepherd et al.
Among 914 patients with treatment-resistant depression (TRD) or major depression with suicidal ideation (MDSI), moderate-to-very severe depression affected 36.5% of those with TRD and 48.3% of those with MDSI. Mean work impairment was 26% and overall impairment 34.7%. Most patients reported no-to-mild impairment in basic needs, social functioning, work, quality of life, and general health. Physicians underestimated the daily-life impact and unmet treatment need. Among 94 patients prescribed esketamine, improvements in clinical global impression occurred in 64.6-77.8% and in activities of daily living in 34-67%, indicating favorable outcomes.
Current Medical Research and Opinion
April 1, 2024
Dina Lešin Gaćina, Darko Marčinko, Tomislav Kuzman et al.
Only 39.8% of primary open-angle glaucoma patients adhered to their medication regimen. Higher scores on the Self-Transcendence character dimension were significantly associated with lower adherence. No other personality dimension from Cloninger's model was linked to adherence. The findings suggest that patients' personality traits, beliefs, and values should be considered in treatment planning to improve medication adherence.