Abstract Treatment-resistant depression (TRD) is commonly operationalized as non-remission after at least two adequately delivered antidepressant trials, but the biological heterogeneity of this population remains substantial. This article presents a translational hypothesis and drug-development framework; it reports no original clinical or laboratory data and is not a systematic review. The...
Abstract Objectives Physical activity and meditation may each relate to mental health, but their joint associations in U.S. adults are unclear. We examined the separate and joint associations of any past-year meditation and meeting physical activity (PA) guidelines with depression and anxiety symptoms. Method We analyzed data from the 2022 National Health Interview Survey Sample Adult file ( n...
Ketamine may have antidepressant and anti-suicidal effects. However, the mechanism underlying ketamine-mediated improvement in cognitive impairment in patients with depression remains unclear. To improve patient cognition in depression using molecular docking and network pharmacology, we examined ketamine's key targets and identified its molecular mechanisms. To gain target information about...
Nightmares are overrepresented in psychiatric disorders and are strongly associated with suicidality, especially in Major Depressive Episode (MDE). This study had two main objectives: (1) to determine an optimal diagnostic cutoff for the Nightmare Severity Index (NSI) to identify Nightmare Disorder (ND), and (2) to compare the clinical profiles of MDE patients with ND (MDE-ND) and without ND...
Background: Major depressive disorder (MDD) is highly prevalent and associated with significant disability and mortality. Treatment-resistant depression (TRD), defined as inadequate response to ⩾2 antidepressant lines, remains a major therapeutic challenge. Esketamine nasal spray, approved in 2019 for TRD, demonstrated efficacy and safety in randomized trials, but real-world evidence remains...
The use of psilocybin for treatment-resistant depression (TRD) is moving towards clinical use, and two unresolved questions will shape what comes next: how large and durable the benefit is, and what produces it? The strongest peer-reviewed efficacy signal is a phase 2b trial, in which one dose of synthetic psilocybin with psychological support approximately doubled the depression-score...
This study investigates the adjunctive effects of mindfulness-based cognitive therapy (MBCT) combined with escitalopram hydrobromide on cognitive function and emotional well-being in older adults with treatment-resistant depression (TRD). We hypothesized that this combined approach would lead to greater enhancements in cognitive abilities and overall well-being compared to escitalopram...
Depression is a complex mental disorder threatening global public health. Its pathophysiological mechanisms involve multidimensional dysfunctions including the emotional-cognitive circuit, Hypothalamic-Pituitary-Adrenal (HPA) axis, neurotransmitter systems and neuroplasticity. Current studies mostly analyze each system in isolation, lacking a unified integrated framework. This review proposes...
This study evaluated the long-term comparative effectiveness and safety of esketamine versus injectable ketamine and esketamine versus oral antidepressants for major depressive disorder (MDD). This emulated target trial utilized observational data from a cohort of U.S. adults with MDD between 2018 and 2024. Patients were categorized into those receiving esketamine, injectable R,S-ketamine, and...
Patients with serious illnesses and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. In this Palliative Care Rounds, we examine the evidence for ketamine/esketamine's efficacy as antidepressants, including evidence specific to people with serious illnesses. In psychiatric...