Treatment-resistant depression: molecular mechanisms and management

Molecular Biomedicine, Journal Year: 2024, Volume and Issue: 5(1)

Published: Oct. 17, 2024

Due to the heterogeneous nature of depression, underlying etiological mechanisms greatly differ among individuals, and there are no known subtype-specific biomarkers serve as precise targets for therapeutic efficacy. The extensive research efforts over past decades have not yielded much success, currently used first-line conventional antidepressants still ineffective close 66% patients. Most clinicians use trial-and-error treatment approaches, which seem beneficial only a fraction patients, with some eventually developing resistance. Here, we review evidence from both preclinical clinical studies on pathogenesis depression antidepressant response. We also discuss efficacy pharmacological non-pharmacological well novel emerging therapies. reveals that in response, specific, but rather involve an interplay between various neurotransmitter systems, inflammatory mediators, stress, HPA axis dysregulation, genetics, other psycho-neurophysiological factors. None current hypotheses sufficiently accounts interactional involved its etiology could partly explain limited success discovering efficacious treatment. Effective management treatment-resistant (TRD) requires targeting several mechanisms, using and/or personalized modalities, could, example, include multi-target pharmacotherapies augmentation psychotherapy approaches. Future guided by interaction provide more insights into potential etiologies TRD, precision biomarker targets, modalities.

Language: Английский

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Adverse Events of Psychological Interventions: Definitions, Assessment, Current State of the Research and Implications for Research and Clinical Practice

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: 93(5), P. 308 - 315

Published: July 29, 2024

Background: The effectiveness of psychological interventions is undisputed. But while in other fields health care the safety studied alongside effectiveness, adverse events (AEs) have only recently been assessed clinical studies interventions. This critical review summarizes definition, assessment and current research status AEs Summary: are defined as any untoward event or unfavorable change that occurs course a intervention. caused by intervention can be classified into side effects correctly applied treatment, malpractice (i.e., incorrectly treatment) unethical conduct (e.g., sexual abuse). Ideally, they independent raters alternatively self-report questionnaires should also cover serious (SAEs, e.g., suicide attempts self-injurious behaviors). About 1 to 2 3 patients report at least AE results meta-analyses suggest treatments might differ frequency and/or severity treatment acceptability (measured dropout rates). Key Messages: Measures SAEs well more nuanced descriptions included all If this happens, we learn with respect AEs, acceptability. As many about equally effective, one day chosen based on differences their profile rather than differential effectiveness. reducing lead effective

Language: Английский

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The Clinical Meaning of Withdrawal with Antidepressant Drugs

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: 93(4), P. 224 - 229

Published: July 18, 2024

Language: Английский

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Neuromodulations in Psychiatric Disorders: Emerging Lines of Definition

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 9

Published: Nov. 14, 2024

Language: Английский

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Rise in Persistent Somatic Syndromes: A Relationship with Systemic Changes in Healthcare?

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 2

Published: Sept. 11, 2024

Language: Английский

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The Journal’s Appreciation

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 2

Published: Dec. 10, 2024

Language: Английский

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