Psychopharmacology bulletin
March 4, 2024
Timothy Whitaker, Kimberly F Farrand, Michael E Thase
249 citations
No approved therapy exists for suicidal ideation and behavior (SI/B) in Major Depressive Disorder (MDD), though ketamine shows rapid antidepressant effects. While FDA-approved esketamine reduced suicidality indicators, its effects did not significantly surpass placebo. Racemic ketamine, a mixture of esketamine and arketamine, may better alleviate SI/B. In an open-label study, 17 hospitalized MDD patients with acute SI/B received intranasal racemic ketamine (SLS-002). Treatment significantly reduced depression and suicidality scores on four clinical scales, including the Montgomery-Åsberg Depression Rating Scale and Sheehan-Suicidality Tracking Scale. SLS-002 was well tolerated with an acceptable safety profile, supporting continued development.
Psychopharmacology bulletin
April 8, 2025
Keming Gao, Buket Koparal, Evrim Bayrak Oruc et al.
99 citations
A patient with treatment-resistant depression and multiple comorbid conditions (generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder) experienced some short-term benefit from electroconvulsive therapy and ketamine infusion. Over a ten-year period from adolescence to adulthood, she had two separate periods of two-year stability, first with compounded ketamine intranasal spray and later with intranasal esketamine. She has been relatively stable without hospitalization or suicide attempt for more than two years on esketamine, suggesting that patients with complex treatment-resistant depression may benefit from ketamine-based treatments at different developmental stages.
Psychopharmacology bulletin
July 8, 2024
Justin Faden, Leslie Citrome
29 citations
Several new psychiatric medications have recently been approved or are nearing approval. Auvelity, a combination of bupropion and dextromethorphan, is a novel antidepressant that speeds up response and remission compared to bupropion alone. Zuranolone, an oral medication for postpartum depression, works in just 14 days and shows improvement lasting 45 days. Gepirone, a 5HT1a receptor partial agonist, was approved for major depression with a favorable side effect profile. Cariprazine was approved as an adjunctive treatment for resistant depression, with easy dosing and lower metabolic side effects.
Psychopharmacology bulletin
February 3, 2025
Anna Mori-Kreiner, Arpit Aggarwal, Meelie Bordoloi
8 citations
Hallucinogen-persisting perception disorder (HPPD) is rare in adolescents. A 16-year-old male with major depressive disorder and polysubstance use (LSD, MDMA, psilocybin, cannabis, benzodiazepines) experienced auditory hallucinations and heightened hearing between MDMA use for eight months, plus auditory and visual hallucinations during a five-day inpatient admission. Treatment with aripiprazole 5 mg led to gradual improvement but not complete resolution. First-line treatments include clonidine and benzodiazepines; second-generation antipsychotics are generally less effective except aripiprazole. The diagnosis was complicated by polysubstance use, requiring distinction from non-substance-induced psychotic disorders.
Psychopharmacology bulletin
June 5, 2026
Michael E Thase, Brian Brennan, Rachael Macisaac et al.
In patients with treatment-resistant depression, a single-day individualized dosing regimen of inhaled GH001 (synthetic mebufotenin) produced rapid and large improvements in depressive symptoms compared with placebo in a Phase 2b trial, with 57.5% achieving remission at Day 8 versus 0% on placebo. A post hoc analysis of 40 patients who received GH001 found no meaningful correlation between the number of prior lifetime antidepressant treatment failures and improvement on the Montgomery-Åsberg Depression Rating Scale at Day 8 or among 6-month open-label extension completers. Remission rates at Day 8 were similar across subgroups with 2, 3, 4, or 5 or more prior failures (range 53.9%-63.6%) and were maintained at Month 6 (range 61.5%-85.7%). The efficacy of GH001 appears largely independent of how many prior antidepressant treatments a patient has tried.
Psychopharmacology bulletin
June 5, 2026
Keming Gao, Evrim Bayrak Oruc, Heather Wobbe et al.
Among six patients with bipolar depression who received both electroconvulsive therapy (ECT) and ketamine infusion (KET-IFU) in routine care, most responded well to ECT, with four showing at least 50% improvement on a depression self-report scale. Half of those who responded to ECT also responded to KET-IFU, though the onset of antidepressant effect differed between treatments. One patient did not respond to either treatment. Subjective memory concerns led five patients to try KET-IFU after ECT, though their cognitive test scores were normal. No patient stopped KET-IFU due to side effects. The findings suggest that some patients with bipolar depression may benefit similarly from both treatments, but head-to-head randomized studies are needed.