International clinical psychopharmacology
September 1, 2023
Mauro Scala, Giuseppe Fanelli, Diana De Ronchi et al.
40 citations
Mood disorders are long-lasting conditions with inconsistent remission rates. Standard antidepressants fail many patients, cause side effects like weight gain and sexual problems, and act slowly. Newer drugs aim to work faster, with fewer side effects, and target symptoms poorly addressed by older medications, such as anhedonia, suicidal thoughts, insomnia, cognitive deficits, and irritability. These agents act on glutamate, GABA, orexin, and other receptors, offering more pharmacodynamic variety to personalize treatment. This review covers the clinical profiles of nine novel compounds—including psilocybin, esmethadone, and zuranolone—to help clinicians weigh benefits and risks for patients with different mood disorder symptoms and comorbidities.
CNS spectrums
December 1, 2024
Mauro Scala, Chiara Fabbri, Paolo Fusar-Poli et al.
8 citations
Psilocybin shows promise for treating mood and anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and substance use disorder, but significant evidence gaps remain. Current studies suggest psilocybin may alleviate depression, anxiety, obsessions, compulsions, and addictive behaviors, yet comparisons with standard antidepressants or anxiolytics are lacking, and optimal dosage, long-term efficacy, and safety are unclear due to trial limitations. Real-world implementation faces challenges including infrastructural requirements, personnel training, cultural stigma, and unresolved legal and ethical issues. Larger, more rigorous studies are needed to substantiate the evidence base before psilocybin can transition from research to clinical practice.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
July 17, 2026
Mauro Scala, Enrico Magrini, Ivana Leccisotti et al.
Suicide remains a leading cause of early death worldwide, and current treatments are limited by slow onset, short durability, or poor tolerability. This narrative review of 34 studies over the past decade examined pharmacological and neuromodulation interventions for suicidal ideation or suicide attempt that are not yet approved for these uses. Across controlled trials, suicidal ideation commonly improved within days to weeks. Some trials reported reductions in suicidal ideation beyond changes in depression scores, suggesting partial independence, though evidence remains inconsistent. Encouraging results were reported for NMDA-related drugs, opioid-system modulation, ayahuasca, and certain neuromodulation techniques, while non-medical cannabis use was associated with worse suicidal ideation trajectories.