Recent studies suggest that ketamine, a widely used anesthetic agent, could offer a wholly new approach to treating severe depression — producing an antidepressant response in hours rather than weeks. Two reviews of recent evidence on ketamine and related drugs for treating depression appear in the Harvard Review of Psychiatry, published by Wolters Kluwer.
Ketamine and related drugs may represent a “paradigm shift” in the treatment of major depressive disorder (MDD) and bipolar depression — especially in patients who do not respond to other treatments, according to a review by Carlos A. Zarate, Jr, MD and colleagues at the National Institute of Mental Health. A second article explores evidence on the mechanisms behind ketamine’s rapid antidepressant effects.
Giving severely depressed patients the arthritis drug celecoxib (Celebrex®) dramatically boosted the effectiveness of their antidepressant medication, a Loyola study has found.
Loyola Medicine psychiatrist Angelos Halaris, MD, PhD, presented the study at the Fifth International Congress on Psychiatry and the Neurosciences in Athens, Greece. Dr. Halaris is a professor in the Department of Psychiatry and Behavioral Neurosciences of Loyola University Chicago Stritch School of Medicine.
The eight-week study enrolled bipolar adults, aged 18 to 65, who were in the depressive phase of their disease and had not benefitted from an antidepressant. (Bipolar disorder is marked by alternating periods of elation and depression, with depression typically lasting longer.) Patients were randomly assigned to receive the antidepressant escitalopram (Lexapro®) plus celecoxib or Lexapro plus a placebo.
Northwestern Medicine scientists have discovered a new pathway in the brain that can be manipulated to alleviate depression. The pathway offers a promising new target for developing a drug that could be effective in individuals for whom other antidepressants have failed.
New antidepressant options are important because a significant number of patients don’t adequately improve with currently available antidepressant drugs. The lifetime prevalence of major depressive disorder is between 10 to 20 percent of the population.
“Identifying new pathways that can be targeted for drug design is an important step forward in improving the treatment of depressive disorders,” said Sarah Brooker, the first author and an M.D./Ph.D student at Northwestern University Feinberg School of Medicine.
Pioneering research by mood disorder experts at Newcastle University has questioned the effectiveness of metyrapone, a drug suggested to treat depression.
It is well recognised that stress can lead to an episode of depressive illness and some patients have raised levels of the stress hormone, cortisol, in their body as an indication of the mental health condition.
Now the largest study of its kind has shown that a drug that blocks production of stress hormone does not routinely help in treating depression. The findings have been published in the journal Lancet Psychiatry.
The study examined the effect of metyrapone — a drug which blocks the production of cortisol — in patients that had not responded to at least two conventional antidepressant drugs.
Using paroxetine — a medication prescribed to treat conditions including depression, obsessive-compulsive disorder, anxiety and posttraumatic stress disorder — during the first trimester of pregnancy may increase newborns’ risk of congenital malformations and cardiac malformations. That’s the conclusion of a recent analysis published in the British Journal of Clinical Pharmacology.
Up to one-fifth of women of childbearing age experience depressive symptoms that often lead to mild to moderate depression, and prescriptions for antidepressants during pregnancy have increased in recent years. The most common drugs for treating depression in pregnant women are selective serotonin reuptake inhibitors, and up until 2005, one drug in that class — paroxetine — was considered to be safe for use during pregnancy. A small unpublished study conducted by the manufacturer, however, suggested an increased risk of cardiac malformations in infants exposed to paroxetine before birth. Subsequent studies using various study designs in different populations across Europe and North America generated conflicting results in terms of statistical significance, although a trend remained towards an increased risk.
More than half of older adults with clinical depression don’t get better when treated with an antidepressant. But results from a multicenter clinical trial that included Washington University School of Medicine in St. Louis indicates that adding a second drug — an antipsychotic medication — to the treatment regimen helps many of those patients.
The findings, from a study of 468 people over age 60 and diagnosed with depression, are published in The Lancet. The study was sponsored by the National Institute of Mental Health and is the largest of its kind ever undertaken in older people with depression.
Previous research in younger patients with depression showed that adding a low dose of the antipsychotic drug aripiprazole (brand name Abilify) helped relieve symptoms of depression when an antidepressant alone wasn’t effective. But the new study is the first to show that the same strategy also works in older adults. The two-drug combination relieved depression in a significant number of patients and also reduced the likelihood that they would have suicidal thoughts.
A new study by researchers at University of Maryland School of Medicine has identified promising compounds that could successfully treat depression in less than 24 hours while minimizing side effects. Although they have not yet been tested in people, the compounds could offer significant advantages over current antidepressant medications.
The research, led by Scott Thompson, PhD, Professor and Chair of the Department of Physiology at the University of Maryland School of Medicine (UM SOM), was published this month in the journalNeuropsychopharmacology.
“Our results open up a whole new class of potential antidepressant medications,” said Dr. Thompson. “We have evidence that these compounds can relieve the devastating symptoms of depression in less than one day, and can do so in a way that limits some of the key disadvantages of current approaches.”
The results come from the first ever large study to compare MBCT — structured training for the mind and body which aims to change the way people think and feel about their experiences — with maintenance antidepressant medication for reducing the risk of relapse in depression.
The study aimed to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. Although the findings show that MBCT isn’t any more effective than maintenance antidepressant treatment in preventing relapse of depression, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.
“Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point,” explains Willem Kuyken, lead author and Professor of Clinical Psychology at the University of Oxford in the UK.