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.
Palliative & supportive care
April 22, 2025
Maria I Lapid, Sandeep R Pagali, Andrea L Randall et al.
9 citations
A systematic review of 14 studies (three randomized controlled trials, five open-label trials, five qualitative studies, and one case report) found that psilocybin-assisted therapy consistently reduced depression, anxiety, and existential distress in patients with life-threatening cancer. Improvements lasted several months. Adverse effects were generally mild and temporary. The review concludes that psilocybin therapy shows potential as an effective treatment for cancer-related psychological distress, but larger, well-designed trials are needed to confirm the findings.
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.
Journal of affective disorders
August 15, 2025
Stefanie Cavalcanti, Vanessa K Pazdernik, Jennifer L Vande Voort et al.
3 citations
Among adults with treatment-resistant depression receiving ketamine or esketamine, those reporting high perceived stress before treatment had lower odds of remission and needed more treatment sessions to achieve remission. In a cohort of 39 patients, 66.7% had high perceived stress. Each 5-point increase on the Perceived Stress Scale reduced the odds of remission by 60%, independent of baseline depression severity. Patients with high stress required a median of 3 treatments to reach remission versus 1 for those with low-to-moderate stress. The observational design and lack of a placebo group limit the findings.
The Journal of clinical psychiatry
January 21, 2026
Matheus G Marques, Aysegul Özerdem, Simon Kung et al.
1 citation
For treatment-resistant depression (TRD), a panel of 10 psychiatrists reached strong consensus on recommending augmentation with second-generation antipsychotics, transcranial magnetic stimulation, and ketamine/esketamine as next-step treatments after three failed antidepressant trials. Treatment preferences shifted to include nonaugmentative antidepressants and electroconvulsive therapy depending on patient characteristics such as metabolic disease and age. The findings underscore the importance of tailoring TRD treatment strategies to individual patient factors beyond conventional guideline tiers.