Depression and anxiety
January 1, 2024
Ludovic Samalin, Lila Mekaoui, Maud Rothärmel et al.
16 citations
In a French real-world study of 157 patients with treatment-resistant depression who began esketamine nasal spray, most discontinued treatment within about 19 weeks. After one month, 40% of those still on the drug showed clinical response and 20% achieved remission. Adverse events occurred in 69% of patients, with serious events in 17%. The findings align with earlier clinical trials, confirming esketamine's role in treating treatment-resistant depression.
European archives of psychiatry and clinical neuroscience
November 17, 2024
Anastasia Demina, Benjamin Petit, Vincent Meille et al.
6 citations
Combining non-invasive brain stimulation with mindfulness-based interventions shows a large effect on anxiety symptoms compared to control interventions, based on a systematic review and meta-analysis of twelve randomized controlled trials. The effect on depression symptoms was small-to-medium and not statistically significant. The combined treatment was feasible and well tolerated. The evidence for anxiety is of moderate certainty, while for depression it is low. Future research should explore which combinations work best by examining neural correlates and should familiarize patients with mindfulness before starting the combined treatment.
International journal of psychiatry in clinical practice
June 1, 2024
Ludovic Samalin, Lila Mekaoui, Pierre De Maricourt et al.
3 citations
An observational study of adults with treatment-resistant depression (TRD) treated with esketamine across three time periods found that patients had moderate-to-severe depression, with an average Montgomery-Åsberg Depression Rating Scale score of 32.6. The 157 treated patients (average age 49.0 years, 66.2% female) showed varied disease severity, subtypes, and comorbidities across cohorts. Later cohorts used esketamine earlier and before other treatments. The findings indicate a high burden of TRD and suggest esketamine is a potentially useful alternative, especially as clinicians gain more familiarity and access.
Neuroscience and biobehavioral reviews
March 1, 2026
Andrew Laurin, Hugo Bottemanne, Samuel Bulteau et al.
2 citations
A review proposes that post-traumatic stress disorder (PTSD) involves disrupted body awareness, specifically the sense of body ownership and sense of agency, which current models overlook. Using predictive processing theory, it distinguishes two PTSD subtypes. In non-dissociative PTSD, hyperprecise trauma-related prior beliefs and heightened interoceptive signals (due to amygdala and anterior insula hyperactivity) produce rigid self-representations, with cognitive processing ranked as prior, interoception, then exteroception. In the dissociative subtype, emotional over-inhibition and anterior insula hypoactivity weaken priors and interoception, while exteroception dominates (exteroception, interoception, prior). Sense of agency impairments are specific to the dissociative subtype, linked to angular gyrus hyperactivity and glutamate hypofunction. The framework suggests a dimensional model of body consciousness disruption across the PTSD spectrum and discusses therapeutic implications for top-down and bottom-up interventions.
European journal of psychotraumatology
December 1, 2026
Maud Rothärmel, Lila Mekaoui, François Kazour et al.
1 citation
In a retrospective study of 22 adults with treatment-resistant depression and comorbid post-traumatic stress disorder who received esketamine nasal spray, trauma re-experiencing episodes occurred during treatment sessions. For 16 patients (72.7%) these episodes disappeared as sessions progressed. Treatment was stopped for 6 patients (27.3%) due to re-experiencing. Among those who continued esketamine, depression response rate was 45.5% and remission 22.7%; PTSD improvement rate was 45.5% and remission 18.2%. The findings suggest esketamine can be safely administered in this comorbid population and that trauma re-experiencing does not prevent clinical improvement.
Journal of psychiatric research
June 1, 2026
Ludovic Samalin, Maud Rothärmel, Lila Mekaoui et al.
In patients with treatment-resistant depression, depressive symptoms improved rapidly during the first four weeks of intranasal esketamine treatment. Among 128 patients in a French real-world study, the average depression rating score fell by 7.5 points after one week and by 13.5 points after four weeks. The proportion of patients whose score dropped by at least half rose from 19.4% at week 1 to 47.4% at week 4. Experiencing dissociation during the first week was linked to a threefold higher chance of response at week 1, but no other factors predicted response. The findings suggest early dissociation may play a role in treatment response, but more research is needed on prognostic factors.