Current evidence for the role of rapid-acting antidepressants (RAAD) in bipolar depression? A perspective and plan for action

Biological Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

After decades of limited progress in depression treatment, recent advancements have sparked renewed interest developing novel antidepressants, particularly rapid-acting antidepressants (RAADs). Despite these promising developments, there remains a significant gap research on bipolar depression. While several antipsychotics been investigated for their efficacy due to the reduced risk mania induction, RAADs, such as (es)ketamine, scarce despite demonstrated safety and effectiveness. This review gives an overview current developments RAADs context disorder. Both published studies well phase II, III IV (based clinicaltrials.gov) are reviewed this work. The following RAAD substance classes or currently possible treatments depression: NMDA antagonists indirect AMPA agonists (ketamine, esketamine, riluzole, felbamate), GABA-A activators positive allosteric modulators (zuranolone, pregnenolone, PEA), psychedelics (psilocybin, 5-MeO-DMT), muscarine receptor (scopolamine), kappa-opioid (navacaprant). Other than well-established (es)ketamine treating depression, has little effort treatment Recent into demonstrates growing field mechanisms action pharmacological However, is urgent need well-controlled clinical expand options improve outcomes millions affected individuals worldwide.

Language: Английский

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Pramipexole Augmentation for Treatment-Resistant Unipolar Depression Not Responding to Aripiprazole Augmentation

Journal of Clinical Psychopharmacology, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

At least 50% of patients with treatment-resistant depression (TRD) fail to respond antidepressant augmentation aripiprazole (AA), currently the strategy best evidence efficacy. The present observational study investigated whether pramipexole (PA) might be useful for who failed AA. We compared short- and long-term effectiveness safety PA in 81 consecutively recruited unipolar TRD, 58 (71.6%) not previously treated AA (UAA) 23 (28.4%) (FAA). FAA UAA groups did differ significantly terms remission, response, improvement, general functioning at 12 24 weeks freedom from relapse months. response rates were 69.6% (n = 16) 77.6% 45), remission 60.9% 14) 74.1% 43), respectively. sustained months 72.7% 8) 84.2% 16), 2 on outcomes (acceptability, tolerability, suicidality suicide attempts) short long term. Our showed that off-label use may a promising treatment TRD had findings are preliminary should interpreted caution due limitations, including flexibility add-on schedule small sample size followed up months, need confirmed larger studies.

Language: Английский

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Subcutaneous Lidocaine Infusion for Chronic Widespread Pain: A Chart Review and Survey Examining the Safety and Tolerability of Treatment

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(7), P. 2440 - 2440

Published: April 3, 2025

Chronic widespread pain (CWP) is characterized by persistent across multiple body regions, often accompanied fatigue, cognitive difficulties, and psychological distress. Background/Objectives: Affecting approximately 10% of the general population, CWP disproportionately impacts women, individuals from lower socioeconomic backgrounds, immigrants, those with a family history chronic pain. Standard treatments, including cognitive-behavioral therapy, exercise, pharmacotherapy, provide insufficient relief. This study explores novel approach to treating treatment-resistant CWP: high-dose subcutaneous lidocaine infusions administered over extended periods. Methods: The research included retrospective chart review patient survey evaluate safety tolerability. protocol started dose 10-12 mg/kg adjusted weight, increasing 10-15% per month, maximum 2000 mg. Results: 27 patients revealed mild moderate adverse events (AEs) in seven patients, no severe AEs. A 15 indicated higher incidence AEs; however, all reported that benefits outweighed negatives. On average, experienced 61% relief, lasting 19 days infusion. Conclusions: demonstrates are well-tolerated treatment for CWP, offering substantial relief improving patients' quality life.

Language: Английский

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Attitudes and Perceptions of Portuguese Psychiatrists and Psychologists on the Clinical Use of Ketamine

Acta Médica Portuguesa, Journal Year: 2025, Volume and Issue: 38(5), P. 297 - 306

Published: May 2, 2025

Introduction: Ketamine has garnered attention for its rapid efficacy in alleviating depressive symptoms treatment-resistant depression, offering a novel mechanism as non-monoaminergic agent. Despite potential, limited research explored mental health professionals’ perspectives on use. This study assesses the attitudes, knowledge, and concerns of Portuguese psychiatrists psychologists regarding clinical application ketamine depression.Methods: A cross-sectional survey was conducted from June 2022 to January 2024 among psychologists. The anonymous online questionnaire assessed perceptions ketamine’s therapeutic utility, risks, knowledge sources. Statistical analyses examined subgroup differences by age, sex, profession, prior psychedelic use.Results: Among 156 participants (mean age = 37.2; 68.6% female), 53.8% were psychologists, 46.2% or trainees Psychiatry. Only 35.9% reported substantial while 59% open integrating it clinically. majority expressed interest training, though 73% raised about inadequate professional training. Significant emerged, with reporting higher levels openness compared younger professionals showed greater training usage.Conclusion: There favorable attitude toward use yet educational gaps remain. Customized addressing background is essential safe effective integration depression. Further studies should focus longitudinal outcomes treatment under standardized protocols ensure safety practice.

Language: Английский

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S-ketamine ameliorates post-stroke depression in mice via attenuation of neuroinflammation, synaptic restoration, and BDNF pathway activation

Biochemical and Biophysical Research Communications, Journal Year: 2025, Volume and Issue: unknown, P. 151965 - 151965

Published: May 1, 2025

Language: Английский

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