This week highlights new strategies for depression treatment, new risks involved with ketamine dosing, and a troubling case report.
New Approaches to Depression Care
Despite the prevalence of major depressive disorder (MDD), treatment often remains a frustrating exercise in trial and error. And despite dozens of approved antidepressants, many patients cycle through multiple options before finding relief. Even so, relapse remains all too common.
A new review in Primary Care Companion for CNS Disorders illustrates how precision medicine might change the game by matching therapies to a patient’s unique biology.
Traditional antidepressants can be effective but side effects and inconsistent response rates conspire to make treatment challenging. Non-drug options (such as electroconvulsive therapy and transcranial magnetic stimulation) expand choices but still leave far too many patients undertreated.
Emerging precision approaches aim to bridge this gap:
- Pharmacogenetic testing, already championed by companies such as GeneSight and Genomind, examines genetic variants that alter drug metabolism – and side effects.
- Researchers are also leveraging machine-learning platforms to harness large clinical datasets to predict treatment response.
- While neuroimaging tools use fMRI and EEG to identify brain signatures linked to antidepressant outcomes.
- Finally, stem cell technology offers what could be the most dramatic shift by creating patient-derived neurons in the lab to test drug effects in a “brain-in-a-dish” model.
While evidence – and opinions – to some of these approaches remains understandably mixed, the field is moving quickly. And the review’s authors argue that these innovations could usher in a new era of personalized psychiatry, where prescribers can move beyond guesswork and deliver faster, safer, and more effective care.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- New research in The Journal of Clinical Psychiatry suggests that higher doses, more frequent dosing, longer treatment duration, and oral administration are all potential risk factors for ketamine-associated uropathy.
- PCC published a case study that covers a healthy 17-year-old boy with no psychiatric family history diagnosed with stress-induced, acute-onset catatonia and Bell’s mania.
- A new commentary in JCP laments the lack of screening efforts despite data that shows that metabolic-related liver diseases disproportionately target people with severe mental disorders.
- A new JCP study reveals that bariatric surgery patients show a lower risk of new mental health diagnoses in the first two years but a higher risk four to eight years later.
- And finally, catch up on the latest in our “Emerging Approaches in Schizophrenia” ongoing series.
