Zafiris J. Daskalakis

2 papers in the library · 466 citations · publishing 2020-2024

Papers

Management of Treatment-Resistant Depression: Challenges and Strategies

Neuropsychiatric Disease and Treatment January 1, 2020 Daphne Voineskos, Zafiris J. Daskalakis, Daniel M. Blumberger 430 citations

Treatment-resistant depression (TRD) is a form of major depressive disorder that does not respond to standard first-line treatments. Although no consensus definition exists, all models require an inadequate response to at least two trials of antidepressant medication. This review compiles meta-analyses, trials, and reviews on TRD challenges and management. It discusses confounds in definitions and staging, difficulties in assessment, and pharmacological augmentation strategies (lithium, triiodothyronine, second-generation antipsychotics, switching antidepressant class). Somatic therapies (electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, deep brain stimulation), psychotherapeutic approaches, and novel treatments (ketamine, psilocybin, anti-inflammatories) are reviewed. The evidence indicates that further large-scale work is needed to understand appropriate treatment pathways and prescribe effective options.

DOI: 10.2147/ndt.s198774 Treatment-resistant depression Major depressive disorder Anxiety Antidepressant +15

A Systematic Review of Study Design and Placebo Controls in Psychedelic Research.

Psychedelic Med (New Rochelle) March 12, 2024 Alexander Wen, Nikhita Singhal, Brett D.M. Jones et al. 36 citations

Blinding is especially difficult in randomized controlled trials of psychedelics because these drugs produce noticeable changes in consciousness. This systematic review of 50 papers from 48 clinical trials published between 1963 and January 2023 found that most studies were double-blinded, used within-subjects designs, and employed inert placebos. The majority did not report on whether blinding procedures were successful, and in those that did, blinding failed. To reduce unblinding and expectancy effects, the authors recommend using active placebos and dose-response or active comparator designs.

DOI: 10.1089/psymed.2023.0028 Full text Psychedelic medicine Clinical research methodology Placebo controls Mental health treatments +1