This systematic review and network meta-analysis (NMA) sought to compare different antidepressant treatments for treatment-resistant depression (TRD) in order to facilitate evidence-based choices. A literature search of PubMed, Cochrane Library, and Embase from inception until April 13th, 2023 identified randomized, controlled trials (RCTs) of adults with depression who had not responded to at...
Ketamine's use in treating bipolar depression must account for risks, such as switching to manic episodes or worsening symptoms. This study examines ketamine's impact on depressive symptoms, focusing on 'inner tension,' 'sleep reduction,' and 'suicidal ideation' over four weeks in treatment-resistant bipolar disorder (TR-BD) patients. Fifty-nine patients with TR-BD were treated consecutively...
Depression is a common and serious psychiatric disorder with significant impacts on individuals. Modified electroconvulsive therapy (MECT) is an established treatment for severe and treatment-resistant depression, but its cognitive side effects, particularly memory impairments, limit its use. Esketamine (ESK), an FDA-approved antidepressant, has shown neuroprotective effects. However, its role...
Abnormalities during rapid eye movement (REM) sleep contribute to the pathophysiology of major depressive disorder (MDD), but few studies have explored the relationship between REM sleep and treatment-resistant depression (TRD). In MDD, REM sleep abnormalities often manifest as alterations in total night REM Density (RD), RD in the first REM period (RD1), and REM Latency (RL). Among these, RD1...
Previous studies have shown patient preference can have large effects on treatment adherence and patient satisfaction. However, the direct effects of matching treatment with patient preference on efficacy and safety outcomes remain unclear. We aimed to evaluate the effects of patient preference and preference-matching on efficacy, adverse events, and adherence to electroconvulsive therapy (ECT)...
We aimed to review clinical research on the safety profiles of antidepressant drugs and associations with maternal depression and neonatal outcomes. We focused on neuroendocrine changes during pregnancy and their effects on antidepressant pharmacokinetics. Pregnancy-induced alterations in drug disposition and metabolism impacting mothers and their fetuses are discussed. We considered evidence...
The INTEGRATE study aimed to provide information on the use, effectiveness, and safety of esketamine nasal spray (ESK-NS) for the treatment of treatment-resistant depression (TRD) in real-world practice in Spain. This was an observational, cross-sectional, retrospective study conducted in adults aged 18-74 years who met the criteria for TRD. The weekly impact of ESK-NS on depressive symptoms...
Emerging viral pathogens, newly reported or rapidly evolving viruses, are a significant public health concern worldwide. Beyond their characteristic clinical presentations, emerging viruses, such as monkeypox virus (MPXV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been increasingly implicated in the development of various neuropsychiatric complications including...
Ketamine, a dissociative anesthetic, has gained widespread use in various medical contexts, including anesthesia, pain management, and treatment-resistant depression. Despite its therapeutic potential, concerns regarding its safety profile have prompted ongoing research and regulatory guidance. This comprehensive literature review explores the current safety considerations of ketamine,...
Treatment-resistant late-life depression (TRLLD) affects nearly half of older adults with major depression. This systematic review evaluates published evidence of effectiveness of both pharmacological and non-pharmacological treatments for TRLLD. A search of MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, and online trial registries up to March 2024 was conducted to identify randomized...
There has been a recent resurgence in research on psychedelics as therapeutic agents for psychiatric conditions. This leading article outlines the studies to date of classic psychedelic treatments for treatment-resistant depression and major depression, including psilocybin, ayahuasca, dimethyltryptamine (DMT), and O-methyl-bufotenine (5-Me-O DMT). We discuss the potential of expanding...
Depression affects over 185 million people worldwide, with approximately one-third classified as treatment-resistant depression (TRD). Current treatments, such as oral antidepressants, often take around 3 weeks to become effective, with no immediate anti-suicidal benefits. The field urgently needs innovative therapies that provide rapid relief. Psychedelics like psilocybin and ayahuasca have...
We present divergent experiences of 2 patients who participated in a clinical trial of psilocybin-assisted cognitive behavioral therapy for major depressive disorder. Both patients participated in an open trial involving 2 drug administration sessions separated by one month (10 and 25 mg, respectively) along with 12 sessions of cognitive behavioral therapy. The first of the 2 patients had...
Depression is a severe and recurrent neuropsychiatric disease with high prevalence, disability, and mortality, which imposes a heavy burden on national public health and the economy. Traditional antidepressants demonstrate delayed effects, low cure rates, and inadequate therapeutic effectiveness for managing treatment-resistant depression. Numerous studies have proved that esketamine, a...
Ketamine is currently gaining attention as a rapid-acting antidepressant for treatment-resistant depression (TRD). However, many patients fail to respond, and limited data exist on predictors of non-response. This study aims to characterize the sociodemographic and clinical features associated with non-response to ketamine among TRD patients. This is a post-hoc analysis of a naturalistic...
Major depressive disorder (MDD) is a debilitating mental health condition characterized by significant morbidity and mortality. The emergence of ketamine infusion therapy has provided a promising, rapidly acting treatment option. We aimed to assess the effectiveness of ketamine infusion therapy as an adjunct treatment in patients with depression and to study the patient's profile undergoing...
Introduction: High-dose psilocybin has shown potential in treating various psychiatric disorders, but its perceptual and cognitive effects, along with the risk of adverse events, highlight the need for alternative treatment approaches. One such approach is the use of low-dose psilocybin, which does not significantly alter cognition or perception. While low-dose psilocybin has garnered growing...
Introduction: Treatment-resistant depression (TRD) affects over 30 % of patients with depression and is associated with high morbidity and mortality. Intravenous (IV) ketamine has shown rapid and robust antidepressant effects for TRD. However, limited data exist on long-term maintenance and patient experiences, especially in North America. This study aims to explore the lived experiences of...
Professional practice guidelines for the use of ketamine in psychiatric practice have been developed by the Royal Australian and New Zealand College of Psychiatrists to provide guidance on the use of ketamine in clinical practice in Australia and Aotearoa New Zealand, based on scientific evidence and supplemented by expert clinical consensus. Articles and information were sourced from existing...
Abstract Psilocybin therapy (PT) is emerging as an effective intervention for Major Depressive Disorder (MDD), offering comparable efficacy to conventional treatments like selective serotonin reuptake inhibitors (SSRIs). Music, an emotionally evocative stimulus, provides a valuable tool to explore changes in hedonic and predictive processing mechanisms via expectancy violations, or ‘surprises’....