Chinese herbal medicines for the treatment of depression: a systematic review and network meta-analysis

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: April 3, 2024

Objectives: Amidst rising global burden of depression and the associated challenges with conventional antidepressant therapies, there is a growing interest in exploring efficacy safety alternative treatments. This study uses Bayesian network meta-analysis to rigorously evaluate therapeutic potential Chinese herbal medicines treatment depression, focusing on their comparative against standard pharmacological interventions. Methods: Five databases (PubMed, Wanfang Data, EMBASE, CNKI, Cochrane Library) grey literature were searched from inception end July 2023 identify studies that assessed treating depression. The response rate, Hamilton Depression Scale (HAMD) scores, rates adverse events through both direct indirect comparisons. Data extraction risk bias assessment meticulously performed. Statistical analysis used Markov chain Monte Carlo methods, effect size estimates provided as odd ratios 95% confidence intervals. Results: A total 198 RCTs involving 8,923 patients analyzed, assessing 17 medicines. Surface Under Cumulative Ranking results indicated top three treatments best rate possibly Guipiwan , Ease Pill Chaihu Jia Longgu Muli Decoction ; reduction HAMD scores Chai Hu Shu Gan San Xingnao Jieyu Xiaoyao Powder lowest effects Alprazolam . Interestingly, commonly synthetic drugs such Fluoxetine Escitalopram Amitriptyline Sertraline Flupentixol Melitracen Venlafaxine not only appeared be less effective than specific ( Mai Da Zao Danzhi-Xiaoyao-San ), but they also related substantially higher events. Conclusion: Our findings elucidate promising viable alternatives certain herbs demonstrating enhanced profiles. outcomes this advocate for integration these modalities into contemporary management paradigms. However, it underscores necessity larger, methodologically robust trials further validate refine preliminary findings. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ identifier CRD42023452109.

Language: Английский

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Astrocytic GABAergic Regulation in Alcohol Use and Major Depressive Disorders

Cells, Journal Year: 2024, Volume and Issue: 13(4), P. 318 - 318

Published: Feb. 9, 2024

Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in central nervous system (CNS). Most GABAergic neurons synthesize GABA from glutamate and release it synaptic cleft CNS. However, astrocytes can also GABA, activating receptors neighboring physiological pathological conditions. As primary homeostatic glial cells brain, play a crucial role regulating homeostasis neurotransmission. Accumulating evidence demonstrates that astrocytic dysregulation implicated psychiatric disorders, including alcohol use disorder (AUD) depressive (MDD), most prevalent co-occurring disorders. Several current medications emerging pharmacological agents targeting levels are clinical trials for treating AUD MDD. This review offers concise summary of regulation We provide an overview understanding areas debate regarding mechanisms by which regulate CNS their potential significance molecular basis MDD, paving way toward future research directions therapeutic target within this field.

Language: Английский

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Dextromethorphan/Bupropion: A Novel Treatment for Patients With Major Depressive Disorder

American Journal of Therapeutics, Journal Year: 2024, Volume and Issue: 31(1), P. e24 - e29

Published: Jan. 1, 2024

Background: Major depressive disorder (MDD) affects millions of people and is the leading cause disability worldwide. Patients report decreased quality life ability to perform activities daily living. It estimated that current standard care, which includes pharmacologic therapy with a selective serotonin reuptake inhibitor, effective in 40%–60%. Additional treatment options are warranted. The combination dextromethorphan (DEX) bupropion (BUP) (Auveulty) was approved for 2022. This unique offers an interesting mechanism action favorable onset patients MDD. Pharmacodynamics Pharmacokinetics: DEX–BUP when used unique. DEX noncompetitive N-methyl- d -aspartate receptor antagonist rapidly metabolized through CYP450 2D6. BUP aminoketone CYP2D6 results increased plasma levels competitive inhibition. Clinical Trials: In phase 2 clinical study, efficacy DEX-BUP compared alone clinically diagnosed At baseline, participants had moderate-to-severe depression using Montgomery–Asberg Depression Rating Scale (MADRS) Global Impressions Severity (CGI-S) scales. There significant overall reduction MADRS CGI-S scores group monotherapy improvement observed as early week 1 treatment. Later, 3 study conducted comparing 45 mg/105 mg placebo Similarly, were significantly reduced group. Adverse effects similar all groups. Therapeutic Advance: response first line MDD reported be Availability additional options, particularly those time efficacy, may improve patient life. option has been shown symptoms after initiation.

Language: Английский

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The emergence of antidepressant drugs targeting GABAA receptors: A concise review

Biochemical Pharmacology, Journal Year: 2024, Volume and Issue: 228, P. 116481 - 116481

Published: Aug. 13, 2024

Depression is among the most common psychiatric illnesses, which imposes a major socioeconomic burden on patients, caregivers, and public health system. Treatment with classical antidepressants (e.g. tricyclic selective serotonine reuptake inhibitors), primarily affect monoaminergic systems has several limitations, such as delayed onset of action moderate efficacy in relatively large proportion depressed patients. Furthermore, depression highly heterogeneus, its different subtypes, including post-partum depression, involve distinct neurobiology, warranting differential approach to pharmacotherapy. Given these shortcomings, need for novel that are superior faster fully justified. The development market introduction rapid-acting accelerated recent years. Some new act through GABAergic In this review, we discuss discovery, efficacy, limitations treatment classic antidepressants. We provide detailed discussion neurotransmission, special focus GABA

Language: Английский

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Xenon gas as a potential treatment for opioid use disorder, alcohol use disorder, and related disorders

Medical Gas Research, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

Xenon gas is considered to be a safe anesthetic and imaging agent. Research on its other potentially beneficial effects suggests that xenon may have broad efficacy for treating health disorders. A number of reviews applications been published, but none focused substance use Accordingly, we review targets relevant the treatment disorders, with focus opioid disorder alcohol disorder. We report inhaled at subsedative concentrations inhibits conditioned memory reconsolidation withdrawal symptoms. work by others reporting antidepressant, anxiolytic, analgesic properties xenon, which could diminish negative affective states pain. discuss research supporting possibility prevent analgesic- or stress-induced tolerance and, so doing reduce risk developing The rapid kinetics, favorable safety side effect profiles, multitargeting capability suggest it used as an ambulatory on-demand rapidly attenuate maladaptive memory, physical symptoms, pain drivers disorders when they occur. also human immunodeficiency virus oncology because exploited target reservoirs, protein-induced abnormalities, cancers. Although expensive, low exert effects, separation, recovery, recycling advancements will lower costs, increasing economic feasibility therapeutic use. More needed better understand remarkable repertoire potential applications.

Language: Английский

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Specific symptomatology profile associated with treatment resistant depression: A multicentric study from the Group for the Study of Resistant Depression with a focus on sex

Journal of Affective Disorders, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Unlocking the Link Between Gut Microbiota and Psychopathological Insights in Anorexia Nervosa: A Systematic Review

European Eating Disorders Review, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 30, 2025

This systematic review explores the associations between qualitative/quantitative changes in gut microbiota and psychopathological symptoms or other clinical features patients with eating disorders (EDs). Secondary outcomes include exploring EDs potential relationships psychotropic drug use. A search was conducted across biomedical databases from inception to June 2024 according PRISMA guidelines. The risk of bias assessed, a narrative synthesis performed due heterogeneity outcomes. Only findings related anorexia nervosa (AN) were identified. Ten studies, which seven longitudinal, two cross-sectional, one interventional (N = 350 AN, 304 HCs), included. Despite no clear links diversity metrics being observed, specific taxa belonging phylum Firmicutes, such as Clostridium, Roseburia, Lactobacillus, Faecalibacterium, Bifidobacterium Actinobacteriota correlated ED psychopathology, including anxiety depressive symptoms. Changes symptoms, well altered behaviours by modulating inflammation insulin pathways through short-chain fatty acids (SCFAs), that also lead neurotransmitter imbalances. Further studies are required replicate these finding explore whether similar patterns observed EDs.

Language: Английский

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Pharmacological Monotherapy for Depressive Disorders: Current and Future, a Narrative Review

Medicina, Journal Year: 2025, Volume and Issue: 61(4), P. 558 - 558

Published: March 21, 2025

Objective: To narratively review currently available antidepressants and future potential as monotherapy for the treatment of depressive disorders. Methods: Selective serotonin reuptake inhibitors (SSRIs), norepinephrine (SNRIs), dopamine inhibitor (bupropion), tricyclic (TCAs), monoamine oxidase (MAOIs) were reviewed according to results from Sequenced Treatment Alternatives Relieve Depression (STAR*D) Study systematic reviews. For rest antidepressants, a PubMed/Medline search was conducted with priority drugs in development disorders, PubMed, Google, Clinicaltrials.gov databases used. Results: The STAR*D demonstrated that sertraline, venlafaxine, bupropion had similar efficacy patients major disorder (MDD) who failed citalopram. A network meta-analyses randomized, placebo-controlled trials found SSRIs, SNRIs, bupropion, TCAs, mirtazapine, agomelatine relative compared placebo, but different acceptability. Gepirone more failed/negative studies smaller effect size placebo other antidepressants. combination dextromethorphan ketamine infusion, intranasal esketamine faster onset action monoamine-based monotherapy. Brexanolone zuranolone are effective postpartum depression (PPD), MDD or adjunctive therapy very small. Psychedelics, glutamate receptor-related agents, kappa opioid receptor antagonists, orexin new anti-inflammatory biomarker-based antidepressant have been under investigation Psychedelics showed action, large size, long durability. Conclusions: Monoamine-based likely continue be mainstream disorder. NMDA antagonists neurosteroid will play bigger role improvement accessibility. may become game changer if phase III validate their safety

Language: Английский

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Anhedonia: Current and future treatments

Psychiatry and Clinical Neurosciences Reports, Journal Year: 2025, Volume and Issue: 4(1)

Published: March 1, 2025

Abstract Anhedonia is a transdiagnostic domain that leads to poor disorder outcome and low remission rates. This narrative review describes broad range of interventions targeting anhedonia, including pharmacological, neuromodulatory, behavioral, lifestyle‐based approaches. Drugs such as vortioxetine, agomelatine, bupropion, ketamine, brexpiprazole show promising anti‐anhedonic effects, while traditional antidepressants, serotonin‐norepinephrine reuptake inhibitors (SNRIs) and, even more so, selective serotonin (SSRIs), are less effective. Neuromodulation techniques, repetitive transcranial magnetic stimulation, direct current transcutaneous auricular vagus nerve proved effective at improving particularly when used in targeted areas. Psychotherapeutic interventions, behavioral activation, mindfulness‐based strategies, savoring also help re‐engage patients with pleasurable activities enhance positive affect. Innovative treatments, aticaprant psilocybin, showed results. Substantial evidence suggests anhedonia better psychosocial functioning, quality life, sustained remission. Although most data come from short‐term studies, several long‐term analyses suggest maintaining hedonic improvements feasible beneficial. The reviewed underscores the importance routine assessment integration symptom‐specific strategies. Tailoring address individual patterns reward disruption may optimize outcomes for anhedonia.

Language: Английский

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Antidepressant treatment in complex clinical pictures

International Clinical Psychopharmacology, Journal Year: 2025, Volume and Issue: 40(3), P. 123 - 126

Published: March 26, 2025

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