CRITICAL REVIEW OF AVAILABLE TREATMENT OPTIONS FOR TREATMENT REFRACTORY DEPRESSION AND ANXIETY - CLINICAL AND ETHICAL DILEMMAS.
Dušan Kolar, Michael V Kolar
Medicinski pregled October 2016 DOI: 10.2298/mpns1606171k (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | Ketamine Stimulant medication Synthetic cannabinoids Medical marijuana |
| Topics | Anxiety Depression |
| Key findings | The author argues that treatments for treatment-resistant mood and anxiety disorders each have important limitations: benzodiazepines lack sustained effects, ketamine's benefits are not lasting and long-term use may risk tolerance and dependence, and stimulant augmentation produces short-lived effects. The author contends that prescribing synthetic cannabinoids and medical marijuana for these conditions raises ethical dilemmas and unresolved questions about optimal treatment. |
Abstract
Treatment-resistant mood and anxiety disorders require an intensive therapeutic approach, and it should balance benefits and adverse effects or other potential detrimental effects of medications. The goal of treatment is to provide consistent and lasting improvement in symptoms of depression and anxiety. Beozodiazepines are effective for anxiety symptoms, but with no sustained treatment effects. Other medication treatment options for anxiety disorders are outlined. Ketamine is usually very effective in treating maior depressive disorder but without sustained benefits. Loog-term use may pose a signiticant risk of developing tolerance and dependence. Stimulant medication augmentation for treatment-resistant depression is effective for residual symptoms of depression, but effects are usually short-lasting and it sounds mor as an artificial way of improving energy, alertness and cognitive functioning. Synthetic cannabinoids and medical marijuana are increasingly prescribed for various medical conditions. but more recently also for patients with mood and anxiety disorders. All of these treatments may raise ethical dilemmas about appropriateness of prescribing these medications and a number of questions regarding the optimal treatment for patients with treatment-resistant depression and treatment refractory 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 2
Cites 2
- Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression American Journal of Psychiatry October 1, 2015
- The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study. Psychoneuroendocrinology January 2015