CNS drugs
August 1, 2024
Liliana Patarroyo-Rodriguez, Stefanie Cavalcanti, Jennifer L Vande Voort et al.
13 citations
Anhedonia, the inability to feel pleasure, is a symptom that appears in many mental disorders beyond just depression and schizophrenia, and it is linked to worse outcomes such as higher suicide risk and poor treatment response. Although brain imaging and biomarkers have improved understanding, the neural basis of anhedonia is still not fully known. Ketamine, a fast-acting antidepressant, also seems to reduce anhedonia through a separate mechanism from its antidepressant effects. Other potential treatments are being explored, but many questions remain, highlighting the need for more research.
Journal of Affective Disorders
January 1, 2024
Liliana Patarroyo-Rodriguez, Vanessa M. Pazdernik, Jennifer L. Vande Voort et al.
12 citations
Sleep disturbances affect 94% of patients with treatment-resistant depression, with middle and early insomnia being the most common. Patients who experience hypersomnia (excessive sleep) before treatment show higher response rates and greater improvement in depressive symptoms after receiving intravenous ketamine or intranasal esketamine. Additionally, 15% of patients have an atypical depression phenotype, and most of them also achieve a positive response with greater symptom reduction. A trend toward faster response is seen in both the hypersomnia and atypical depression groups. These sleep-related features may help predict which patients will benefit from ketamine-based treatments.
Therapeutic advances in psychopharmacology
January 1, 2025
Ahmed Elmosalamy, Idil Tarikogullari, Liliana Patarroyo-Rodriguez et al.
7 citations
About one-third of people with depression do not respond to standard treatments, a condition known as treatment-resistant depression (TRD). Intravenous (IV) ketamine and esketamine (given IV or as a nasal spray) are newer options for TRD, but only the nasal spray version of esketamine is FDA-approved. A meta-analysis of eight studies with 978 adults directly comparing IV ketamine with esketamine found that both treatments produced similar rates of response and remission after acute treatment, with a slight but not statistically significant advantage for IV ketamine. IV ketamine may work faster, but the evidence is mostly from observational studies, and large randomized trials are needed to confirm these findings.
CNS drugs
February 1, 2026
Matheus G Marques, Liliana Patarroyo-Rodriguez, Balwinder Singh
Bipolar disorder affects about 40 million people worldwide, with depression as its most disabling phase. Current treatments often work slowly, prompting interest in psilocybin, a psychedelic compound being studied in clinical trials combined with psychotherapy. Early research in bipolar II disorder (19 participants) shows encouraging results, but evidence is limited. Safety concerns include risk of mood switching and drug interactions. Regulatory hurdles, infrastructure needs, and uncertainties about the role of the psychedelic experience, especially with common bipolar medications, remain. Cautious research is needed to assess psilocybin's safety and efficacy for bipolar depression, particularly for bipolar I disorder and long-term outcomes.