Psychotropic Drug–Related Weight Gain and Its Treatment

American Journal of Psychiatry, Год журнала: 2024, Номер 181(1), С. 26 - 38

Опубликована: Янв. 1, 2024

Psychotropic drug–related weight gain (PDWG) is a common occurrence and highly associated with non-initiation, discontinuation, dissatisfaction psychiatric drugs. Moreover, PDWG intersects the elevated risk for obesity morbidity that has been amply reported in population. Evidence indicates differential liability exists antipsychotics, antidepressants, anticonvulsants. During past two decades, agents within these classes have become available significantly lower or no as such should be prioritized. Although lithium gain, overall extent of than previously estimated. The benefit lifestyle behavioral modification and/or populations established, effectiveness similar to general Metformin most studied pharmacological treatment prevention PDWG, promising data are emerging glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., liraglutide, exenatide, semaglutide). Most pharmacologic antidotes supported low-confidence topiramate, histamine-2 antagonists). Future vistas include large, adequately controlled studies GLP-1 possibly GLP-1/glucose-dependent insulinotropic polypeptide co-agonists tirzepatide) well specific dietary modifications.

Язык: Английский

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Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin

Med, Год журнала: 2024, Номер 5(3), С. 190 - 200.e5

Опубликована: Фев. 14, 2024

Язык: Английский

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Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research

American Journal of Psychiatry, Год журнала: 2025, Номер 182(1), С. 21 - 32

Опубликована: Янв. 1, 2025

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain are effective safe treatment of major depressive disorder, treatment-resistant depression, posttraumatic stress disorder. Preliminary evidence also supports efficacy other disorders (e.g., tobacco alcohol use disorders). Notwithstanding promise psychedelics, concerns have arisen with respect to interpretability translatability study results. For example, aspects related short- long-term safety, abuse liability, essentiality psychedelic "trip" psychological support are, inter alia, insufficiently characterized agents. The overarching aims this overview 1) review methodological affect inferences interpretation extant studies disorders, 2) provide guidance future development psychiatry, critical clinical implementation.

Язык: Английский

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Systematic review of clinical effectiveness of interventions for treatment resistant late-life depression

Ageing Research Reviews, Год журнала: 2025, Номер unknown, С. 102710 - 102710

Опубликована: Фев. 1, 2025

Treatment-resistant late-life depression (TRLLD) affects nearly half of older adults with major depression. This systematic review evaluates published evidence effectiveness both pharmacological and non-pharmacological treatments for TRLLD. A search MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, online trial registries up to March 2024 was conducted identify randomized controlled trials (RCTs) evaluating interventions Seven studies assessed (antidepressants, antipsychotics, mood stabilizers, or ketamine) another seven examined approaches (psychotherapy, electroconvulsive therapy, repetitive transcranial magnetic stimulation (rTMS), computerized cognitive remediation). Aripiprazole (2 studies), venlafaxine (1 study), ketamine lithium study) were associated a reduction in depressive symptoms post-treatment compared comparator treatment group. rTMS sequential bilateral theta burst remediation also showed significant improvements Quality varied from very low medium among included studies. Most reported data on small sample sizes. We identified number RCTs augmentation appears be an effective based two studies, acceptable side effect profile. Other may effective, but is low-quality evidence. Future large-scale are urgently needed draw firm conclusions.

Язык: Английский

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The rapid antidepressant effectiveness of repeated dose of intravenous ketamine and intranasal esketamine: A post-hoc analysis of pooled real-world data

Journal of Affective Disorders, Год журнала: 2023, Номер 348, С. 314 - 322

Опубликована: Дек. 23, 2023

Язык: Английский

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The definition of treatment resistance in anxiety disorders: a Delphi method‐based consensus guideline

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 113 - 123

Опубликована: Янв. 12, 2024

Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials innovative therapeutic interventions. However, an explicit definition treatment-resistant anxiety (TR-AD) informing such is currently lacking. We used Delphi method-based consensus approach to provide internationally agreed, consistent clinically useful operational criteria for TR-AD in adults. Following summary the current state knowledge based on international guidelines available systematic review, survey free-text responses 29-item questionnaire relevant aspects TR-AD, online meeting, panel 36 multidisciplinary experts stakeholders voted anonymously written statements three rounds. Consensus was defined as ≥75% agreeing statement. The agreed set 14 recommendations providing detailed pharmacological and/or psychotherapeutic treatment, well potential staging model. also evaluated further regarding epidemiological subgroups, comorbidities biographical factors, terminology vs. "difficult-to-treat" preferences attitudes persons these future research directions. This expected serve systematic, practical guideline aid designing mechanistic studies facilitate purposes. effort could ultimately lead development more effective evidence-based stepped-care algorithms patients disorders.

Язык: Английский

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A comparison between psilocybin and esketamine in treatment-resistant depression using number needed to treat (NNT): A systematic review

Journal of Affective Disorders, Год журнала: 2024, Номер 350, С. 698 - 705

Опубликована: Янв. 21, 2024

Язык: Английский

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Algorithm‐based modular psychotherapy vs. cognitive‐behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof‐of‐concept randomized controlled trial

World Psychiatry, Год журнала: 2024, Номер 23(2), С. 257 - 266

Опубликована: Май 10, 2024

Effect sizes of psychotherapies currently stagnate at a low‐to‐moderate level. Personalizing psychotherapy by algorithm‐based modular procedures promises improved outcomes, greater flexibility, and better fit between research practice. However, evidence for the feasibility efficacy modular‐based psychotherapy, using personalized treatment algorithm, is lacking. This proof‐of‐concept randomized controlled trial was conducted in 70 adult outpatients with primary DSM‐5 diagnosis major depressive disorder, score higher than 18 on 24‐item Hamilton Rating Scale Depression (HRSD‐24), least one comorbid psychiatric according to Structured Clinical Interview (SCID‐5), history “moderate severe” childhood maltreatment domain Childhood Trauma Questionnaire (CTQ), exceeding cut‐off value three measures early trauma‐related transdiagnostic mechanisms: Rejection Sensitivity (RSQ), Interpersonal Reactivity Index (IRI), Difficulties Emotion Regulation Scale‐16 (DERS‐16). Patients were 20 sessions either standard cognitive‐behavioral therapy alone (CBT) or CBT plus modules mechanism‐based algorithm (MoBa), over 16 weeks. We aimed assess MoBa, compare MoBa vs. respect participants’ therapists’ overall satisfaction ratings therapeutic alliance (using Working Alliance Inventory ‐ Short Revised, WAI‐SR), efficacy, impact mechanisms, safety. The outcome HRSD‐24 post‐treatment. Secondary outcomes included, among others, rate response (defined as reduction 50% from baseline <16 post‐treatment), remission ≤8 improvements mechanisms social threat response, hyperarousal, processes/empathy. found no difficulties selection individual patients, applying above‐mentioned cut‐offs, implementation MoBa. Both participants therapists reported had WAI‐SR CBT. approaches led reductions symptoms post‐treatment, non‐significant superiority nearly times likely experience end (29.4% 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9‐11.6). Among patients showed significantly post‐treatment effect processes/empathy (p<0.05) compared who presented an exacerbation this Substantially less adverse events These results suggest acceptability complementing depressed comorbidities trauma. While initial observed, potential clinical advantages interindividual heterogeneity will have be investigated fully powered confirmation trials.

Язык: Английский

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Projecting the 10-year costs of care and mortality burden of depression until 2032: a Markov modelling study developed from real-world data

The Lancet Regional Health - Western Pacific, Год журнала: 2024, Номер 45, С. 101026 - 101026

Опубликована: Фев. 6, 2024

Based on real-world data, we developed a 10-year prediction model to estimate the burden among patients with depression from public healthcare system payer's perspective inform early resource planning in Hong Kong.

Язык: Английский

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Number needed to treat (NNT) for ketamine and esketamine in adults with treatment-resistant depression: A systematic review and meta-analysis

Journal of Affective Disorders, Год журнала: 2024, Номер 356, С. 753 - 762

Опубликована: Апрель 16, 2024

Язык: Английский

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