For patients with difficult-to-treat depression who do not respond to at least two antidepressant trials, remission rates are significantly lower than the 67% seen with initial or secondary pharmacological treatment. Brain stimulation procedures and novel substances offer innovative and effective options to complement standard therapies. This overview covers repetitive transcranial magnetic stimulation, electroconvulsive therapy, ketamine/esketamine, transcranial direct current stimulation, deep brain stimulation, and psychedelic-assisted psychotherapy, with an outlook on individualized, procedure-specific indications.
Alcohol use disorders are a major contributor to the global disease burden. After the acute withdrawal phase, the main goal of post-acute treatment is long-term abstinence, though reducing consumption is also recognized as an intermediate aim. In Switzerland, four medications—acamprosate, naltrexone, nalmefene, and disulfiram—are approved for this phase and have well-established efficacy in reducing relapse risk, drinking days, and overall alcohol consumption. Off-label use of baclofen, topiramate, and gabapentin lacks sufficient evidence of effectiveness. Emerging treatments such as cannabidiol, psilocybin, and glucagon-like peptide-1 receptor agonists show promising potential that requires further clinical confirmation. Pharmacological interventions can improve patient outcomes, reduce inpatient treatment needs, and lower healthcare costs.