New and emerging treatments for major depressive disorder.
BMJ (Clinical research ed.) July 8, 2024 Cecilia Njenga, Parashar Pravin Ramanuj, Frederico Jose Coelho De Magalhães et al. 44 citations
Major depressive disorder (MDD) affects many people, but its underlying causes remain unclear. Treatment resistance points to the disorder's heterogeneity and the need for therapies beyond monoamine neurotransmission. This review examines emerging targets for MDD, including psychedelics, antibiotics, opioid modulators, neuropeptides, and onabotulinumtoxin, as well as neuromodulatory treatments like light-based therapies, magnetic stimulation, and electrical stimulation. Most interventions were tested as add-ons to antidepressants. Research on psychedelics is most advanced, with trials suggesting rapid antidepressant and anti-suicidal effects. The review considers trial findings, tolerability, study design limitations, and research quality. Currently, forming recommendations is challenging, but future research may allow more robust guidance.