[Clinical management of treatment-resistant depression].
Bernhard T Baune, Sarah E Fromme, Maximilian Kiebs, René Hurlemann
Der Nervenarzt May 1, 2024 DOI: 10.1007/s00115-024-01647-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | Esketamine psychedelics esmethadone dextromethorphan anti-inflammatory strategies |
| Topics | Depression |
| Keywords | Experimental treatment Glutamatergic system Off-label use Pharmacological therapy Psychedelics Depression treatment Antidepressant therapy Experimental psychiatry Glutamate research Psychedelic medicine |
| Citations | 1 |
| Key findings | Pharmacological approaches focusing on glutamatergic modulation or psychedelics are particularly important for developing fast-acting, well-tolerated treatments for treatment-resistant depression. |
Abstract
Treatment-resistant depression (TRD) is a complex disorder. Although no standardized definition has been established to date, there are promising and well-established treatment options for the condition. Looking at the current pharmacological and neuromodulatory strategies, there is an urgent need for fast-acting and well-tolerated treatment options. The search for new mechanisms of action goes beyond the monoamine hypothesis. For example, esketamine is already an established treatment method that is fast-acting and well tolerated, while psychedelics or esmethadone are currently still undergoing clinical trials. Compounds that can be used off-label, such as dextromethorphan or anti-inflammatory strategies are also presented. Pharmacological approaches that focus on the modulation of the glutamatergic system or belong to the class of psychedelics, appear to be of particular importance for current research and development. These particularly include substances that rapidly exert clinical effects and have a favorable side-effect profile.
Comparable studies
Other narrative reviews on depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synaptic Dysfunction in Depression: Potential Therapeutic Targets | 2012 | Review | |
| Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse | 2003 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population | 2019 | Integrative review | |
| Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | 2005 | Review |
Citations in the library
Cites 10
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression JAMA Psychiatry December 27, 2017
- Single-Dose Psilocybin Treatment for Major Depressive Disorder JAMA August 31, 2023
- Novel drug developmental strategies for treatment‐resistant depression British Journal of Pharmacology November 25, 2021
and 5 more in the library