Addictive potential of novel treatments for refractory depression and anxiety
Neuropsychiatric Disease and Treatment June 1, 2018 DOI: 10.2147/ndt.s167538 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | Ketamine stimulant medication synthetic cannabinoids medicinal cannabis benzodiazepines |
| Topics | Anxiety Depression |
| Citations | 38 |
| Key findings | The authors conclude that benzodiazepines, ketamine, stimulant medications, and cannabinoids share common characteristics, including short-lasting benefits and a risk of prescription medication addiction with longer use. They argue this raises ethical dilemmas about long-term prescribing for patients with depression and anxiety disorders. |
Abstract
Treatment-resistant mood disorders and anxiety disorders require intensive treatment, but treatment options should balance benefits and adverse effects or other potential detrimental effects on patients, including the risk of developing prescription medication addiction. Some of the newer treatment modalities for mood and anxiety disorders may have similar properties to benzodiazepines. The goal of this review was to identify the potential for developing dependence on the novel treatment approaches to treatment-resistant depression and refractory anxiety disorders. PubMed, MEDLINE, PsycINFO, Ovid, Cochrane Library, and Google Scholar were searched. Ketamine is effective in improving symptoms of major depressive disorder, but with no sustained benefits. Long-term use of oral or intranasal ketamine formulations may be associated with the risk of developing dependence. Augmentation of stimulant medication is usually effective for residual symptoms of depression, but the effects are usually short lasting and there is a potential for abuse. Synthetic cannabinoids and medicinal cannabis are increasingly being prescribed for a number of medical conditions, including anxiety disorders, without enough evidence about their efficacy and with the risk of patients developing dependence. In summary, benzodiazepines, ketamine, stimulant medications, and cannabinoids have some common characteristics, including short-lasting benefits and the risk of developing prescription medication addiction with longer use. All of these treatments may raise ethical dilemmas about the appropriateness of prescribing these medications in the long run for patients with depression and anxiety disorders.
Comparable studies
Other narrative reviews on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-based interventions: an overall review General (healthcare, schools, workplace) | 2021 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement | |
| Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | 2005 | Review | |
| Mindfulness Meditation and Psychopathology | 2018 | Review | |
| Management of Treatment-Resistant Depression: Challenges and Strategies | 2020 | Review |
Citations in the library
Cited by 8
- A Phase 2 Open Label Study of Efficacy, Safety, and Tolerability of SLS-002 (Intranasal Racemic Ketamine) in Adults with MDD at Imminent Risk of Suicide. Psychopharmacology Bulletin March 4, 2024
- Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review BJPsych Open December 23, 2021
- Trait dissociation as a predictor of induced dissociation by ketamine or esketamine in treatment-resistant depression: Secondary analysis from a randomized controlled trial. Journal of Psychiatric Research May 8, 2021
- Psychiatry might need some psychedelic therapy International Review of Psychiatry July 4, 2018
- Policy Considerations for Psychedelics in Research and Medicine – What’s Next on the Schedule? Journal of Science Policy & Governance July 2, 2026
and 3 more in the library
Cites 10
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013
- Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression JAMA Psychiatry December 27, 2017
- Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression American Journal of Psychiatry October 1, 2015
- Ketamine for chronic pain: risks and benefits British Journal of Clinical Pharmacology February 21, 2013
- To use or not to use: an update on licit and illicit ketamine use Substance Abuse and Rehabilitation March 1, 2011
and 5 more in the library