Ketamine, a non-competitive NMDA receptor antagonist, produces rapid antidepressant effects in treatment-resistant depression and suicidal ideation through NMDA receptor blockade, AMPA receptor activation, and upregulation of BDNF/mTOR signaling. Its enantiomers esketamine and R-ketamine differ in efficacy and mechanisms. Intranasal esketamine has been approved in Europe, the United States, and China for treatment-resistant depression, showing rapid alleviation of depressive symptoms and acute suicidal ideation. R-ketamine may offer longer-lasting effects and an improved safety profile. Safety concerns include dissociation, cognitive impairment, and abuse liability.
Adding group mindfulness-based stress reduction therapy (MBSR) to routine care and health education for patients with stable chronic obstructive pulmonary disease (COPD) reduced depression scores and improved mindfulness and clinical symptom scores over eight weeks, but did not change lung function as measured by FEV1%pred. The study assigned 97 patients to either an MBSR group or a control group; 83 completed the trial. Depression, mindfulness, and COPD symptom scores all showed significant improvement in the MBSR group compared with controls at four and eight weeks. No between-group differences in pulmonary function were observed.
An 8-week mindfulness-based childbirth intervention, added to routine nursing, was associated with lower fear scores (30.46 vs. 43.24 on the Childbirth Attitudes Questionnaire), lower pain ratings (6.64 vs. 7.32 on the Numerical Rating Scale), a shorter labor course (10.10 vs. 13.28 hours), and a higher vaginal delivery rate (84.00% vs. 60.00%) compared with routine nursing alone. The authors conclude that mindfulness-based childbirth may alleviate labor fear and pain, shorten labor, and promote vaginal delivery.