Brain Sciences,
Год журнала:
2025,
Номер
15(2), С. 161 - 161
Опубликована: Фев. 6, 2025
Background/Objectives:
Non-response
to
initial
treatment
options
for
major
depressive
disorder
(MDD)
is
a
common
clinical
challenge
with
profound
deleterious
impacts
affected
patients.
Few
treatments
have
received
regulatory
approval
treatment-resistant
depression
(TRD).
Methods:
A
systematic
search
of
United
States
and
European
Union
trials
registries
was
conducted
identify
Phase
II,
III,
or
IV
trials,
last
update
posted
on
after
1
January
2020,
that
were
evaluating
medications
TRD.
For
both
the
US
EU
registries,
condition
term
"treatment
resistant
depression"
associated
lower-level
terms
(per
registry
protocol)
used.
registry,
secondary
using
"depressive
disorders"
modifying
"inadequate"
also
performed
capture
registrations
not
tagged
as
Two
additional
searches
in
"suicide"
"anhedonia"
transdiagnostic
targets
investigational
medications.
Trials
categorized
based
primary
mechanism
action
trial's
medication.
Results:
Fifty
TRD,
20
anhedonia,
25
suicide
identified.
Glutamate
system
modulation
currently
most
compounds
development,
including
antagonists
allosteric
modulators
NMDA
receptors,
AMPA
metabotropic
type
2/3
glutamate
intracellular
effector
molecules
downstream
signaling.
Psychedelics
seen
greatest
surge
among
mechanistic
past
5
years,
however,
psilocybin
particular
garnering
significant
attention.
Other
mechanisms
included
GABA
modulators,
monoamine
anti-inflammatory/immune-modulating
agents,
an
orexin
2
receptor
antagonist.
Conclusions:
These
investigations
offer
substantial
promise
more
efficacious
potentially
personalized
medication
approaches
Challenges
detecting
efficacy
TRD
include
heterogeneity
within
population
stemming
from
presumed
variety
biological
dysfunctions
underlying
disorder,
comorbid
disorders,
chronic
psychosocial
stressors,
enduring
effects
prior
serotonergic
antidepressant
treatments.
Frontiers in Psychology,
Год журнала:
2024,
Номер
15
Опубликована: Ноя. 4, 2024
Results
from
multiple
recent
studies
support
further
evaluation
of
3,4-methylenedioxymethamphetamine
(MDMA)
in
conjunction
with
psychotherapy
(i.e.,
MDMA-Assisted
Therapy)
the
treatment
post-traumatic
stress
disorder
(PTSD).
In
two
Phase
3
trials,
Therapy
comprised
a
short-term,
intensive
that
included
three
sessions
directly
facilitated
by
MDMA
(referred
to
as
“experimental
sessions”),
well
number
non-drug
sessions.
This
model
aimed
harness
potential
facilitate
recall
and
processing
traumatic
memories,
increase
learning
social
context,
integrating
“top-down”
“bottom-up”
approaches
trauma-focused
care.
To
date,
conceptual
framework
for
this
has
not
been
described
scientific
literature.
omission
contributed
misunderstandings
about
both
theoretical
underpinnings
modality
therapeutic
approach
emerges
it.
paper
delineates
psychotherapeutic
concepts,
theories,
historical
antecedents
underlying
inner-directed
PTSD.
Broadly
speaking,
centered
concept
participant’s
inner
healing
intelligence
primary
agent
change,
relationship
being
core
facilitative
condition
fostering
self-directed
movement
toward
recovery
growth.
Corollaries
holistic,
self-directed,
relational,
trauma-informed
include
non-pathologizing
embodied
experience
(including
possibility
intense
emotional
somatic
expression,
experiences
multiplicity,
suicidal
ideation,
multigenerational
transpersonal
experiences),
therapists’
own
psychodynamic,
somatic,
awareness,
empathic
attunement,
relational
skillfulness,
cultural
humility.
The
use
platform
outperformed
placebo
2
measured
symptom
reduction
participants
However,
within-group
comparisons
also
identified
significant
who
did
receive
MDMA,
lending
empirical
itself.
addition
comparative
efficacy
future
research
should
investigate
which
elements
underlie
clinical
benefit
individuals
npj Mental Health Research,
Год журнала:
2024,
Номер
3(1)
Опубликована: Июль 2, 2024
Abstract
Pre-prohibition
psychedelic
research
with
complex
psychiatric
patients
generated
a
wealth
of
treatment
methodologies
and
practices,
providing
invaluable
clinical
insights
pertaining
to
the
medical
administration
psychedelics
in
various
mental
health
diagnoses.
Building
upon
these
early
studies,
which
lack
rigor
tools
available
today,
contemporary
has
focused
on
investigating
safety
efficacy
randomized
controlled
trials
via
psychometric
measures
symptom
assessments.
Both
then
now,
context
role
clinicians
been
recognized
as
an
essential
feature
for
positive
patient
outcomes.
To
broaden
knowledge
base
modern
support
training
conducting
medically
supervised
this
paper
provides
review
pre-prohibition
narratives
phenomenology
non-pharmacological
factors
experience.
Lastly,
explores
range
clinician
perspectives
psychological
interventions
employed
inform
future
directions
best
practice
guidelines.
European Psychiatry,
Год журнала:
2025,
Номер
68(1)
Опубликована: Янв. 1, 2025
Abstract
Background
Recent
years
show
an
exponential
increased
interest
(“renaissance”)
in
the
use
of
psychedelics
for
treatment
mental
disorders
and
broader.
Some
these
treatments,
such
as
psilocybin
depression,
are
process
formal
regulation
by
regulatory
bodies
US
(FDA)
Europe
(EMA),
on
brink
real-world
implementation.
In
slipstream
developments
increasing
commercial
initiatives
taking
shape.
The
European
Psychiatric
Association
(EPA)
acknowledges
both
therapeutic
potential
psychedelic
substances
challenges
research
clinical
Steps
need
to
be
taken
toward
a
well-balanced
policy
based
upon
sound
scientific
evidence
research,
aiming
at
safe,
ethical
responsible
integration
therapy
available
all
patients
who
can
potentially
benefit.
Methods
this
EPA
paper,
we
highlight
benefits,
also
which
relevant
future
implementation
treatments.
Results
addition
overview
current
hypotheses
working
mechanisms
treatment,
paper
specifically
highlights
importance
psychosocial
components
well
professional
aspects
playing
role
Conclusions
Four
recommendations
formulated
further
Brain Sciences,
Год журнала:
2025,
Номер
15(2), С. 161 - 161
Опубликована: Фев. 6, 2025
Background/Objectives:
Non-response
to
initial
treatment
options
for
major
depressive
disorder
(MDD)
is
a
common
clinical
challenge
with
profound
deleterious
impacts
affected
patients.
Few
treatments
have
received
regulatory
approval
treatment-resistant
depression
(TRD).
Methods:
A
systematic
search
of
United
States
and
European
Union
trials
registries
was
conducted
identify
Phase
II,
III,
or
IV
trials,
last
update
posted
on
after
1
January
2020,
that
were
evaluating
medications
TRD.
For
both
the
US
EU
registries,
condition
term
"treatment
resistant
depression"
associated
lower-level
terms
(per
registry
protocol)
used.
registry,
secondary
using
"depressive
disorders"
modifying
"inadequate"
also
performed
capture
registrations
not
tagged
as
Two
additional
searches
in
"suicide"
"anhedonia"
transdiagnostic
targets
investigational
medications.
Trials
categorized
based
primary
mechanism
action
trial's
medication.
Results:
Fifty
TRD,
20
anhedonia,
25
suicide
identified.
Glutamate
system
modulation
currently
most
compounds
development,
including
antagonists
allosteric
modulators
NMDA
receptors,
AMPA
metabotropic
type
2/3
glutamate
intracellular
effector
molecules
downstream
signaling.
Psychedelics
seen
greatest
surge
among
mechanistic
past
5
years,
however,
psilocybin
particular
garnering
significant
attention.
Other
mechanisms
included
GABA
modulators,
monoamine
anti-inflammatory/immune-modulating
agents,
an
orexin
2
receptor
antagonist.
Conclusions:
These
investigations
offer
substantial
promise
more
efficacious
potentially
personalized
medication
approaches
Challenges
detecting
efficacy
TRD
include
heterogeneity
within
population
stemming
from
presumed
variety
biological
dysfunctions
underlying
disorder,
comorbid
disorders,
chronic
psychosocial
stressors,
enduring
effects
prior
serotonergic
antidepressant
treatments.
