The International Journal of Neuropsychopharmacology
February 1, 2025
Clara Cavallotto, Giacomo D’andrea, Andrea Miuli et al.
1 citation
In patients with treatment-resistant depression, combining the antidepressant vortioxetine with esketamine nasal spray was as effective as the standard combination of an SSRI or SNRI with esketamine in reducing depressive symptoms over three months. The vortioxetine combination showed a larger effect in reducing emotional blunting and was linked to fewer treatment-emergent side effects, including dissociative symptoms. These findings suggest vortioxetine plus esketamine may be a valuable alternative, though larger randomized trials are needed to confirm the results.
Journal of Substance Use and Addiction Treatment
July 1, 2026
Alessio Mosca, Stefania Chiappini, Andrea Miuli et al.
Management of ketamine misuse relies on supportive care, psychotherapy, and off-label medications, but robust evidence is lacking. A systematic review of 73 studies found that approaches include symptomatic medical care, psychotherapeutic interventions such as motivational interviewing and cognitive-behavioral therapy, and pharmacological treatments including benzodiazepines, SSRIs, naltrexone, lamotrigine, and gabapentinoids, with varying effectiveness. Multidisciplinary strategies addressing both psychiatric and somatic complications, such as 'K-bladder' and 'K-cramps', are essential. High relapse rates and limited follow-up weaken the evidence, and there is an urgent need for controlled studies and standardized treatment protocols.
Frontiers in Psychiatry
January 8, 2024
V. Ricci, Ilenia di Muzio, F. Ceci et al.
Patients with first-episode psychosis who use synthetic cannabinoids (SPICE) experience more severe and persistent positive symptoms and less improvement in aberrant salience—the tendency to assign excessive meaning to neutral stimuli—compared with natural cannabis users and non-users. Non-users show better recovery in global functioning. Aberrant salience scores decline over six months in all groups, but SPICE-users start higher and improve less. Negative symptoms are most prominent among non-users. These findings may help clinicians tailor diagnosis and treatment for substance-induced versus non-substance-related psychosis.