[Interventional psychiatric procedures and novel substances for the treatment of affective disorders: An overview and outlook].
Therapeutische Umschau. Revue therapeutique – April 01, 2025
Source: PubMed
Summary
Breakthrough treatments are transforming care for treatment-resistant depression. Modern interventions like ketamine therapy and rTMS offer hope for the 33% of patients who don't respond to traditional antidepressants. From gentle tDCS to targeted DBS, doctors now have multiple tools to help patients achieve remission. ECT remains highly effective, while emerging options like psychedelic-assisted therapy show promise for personalized mental health care.
Abstract
Depression is one of the most common mental disorders. The effectiveness of pharmacological and psychotherapeutic treatments is well documented. Remission rates are around 67 % for pharmacological antidepressant initial and secondary treatment of a depressive episode in unipolar disorders. However, patients with a depressive episode who do not respond to at least two successive attempts at pharmacological antidepressant treatment have significantly lower remission rates. Particularly in this subgroup with difficult-to-treat depression, brain stimulation procedures and treatment with novel substances represent innovative and effective treatment options that complement pharmacotherapy and psychotherapy. The aim of this paper is to provide an overview and outlook on the following treatment procedures: repetitive transcranial magnetic stimulation (rTMS), electroconvulsive therapy (ECT), ketamine/esketamine, transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and psychedelic-assisted psychotherapy (PAT). An outlook on selected current developments with the aim of a procedure-specific, individualized indication will be given.