BMJ (Clinical research ed.)
April 10, 2024
Shuo Wang, Chun-Mei Deng, Yuan Zeng et al.
64 citations
A single low dose of esketamine given after childbirth reduces the risk of a major depressive episode at 42 days postpartum by about three quarters in mothers with prenatal depression. In a randomized trial of 364 mothers with at least mild prenatal depression, 6.7% of those receiving esketamine experienced a major depressive episode compared with 25.4% in the placebo group. Depression scores were also lower in the esketamine group at 7 and 42 days. Neuropsychiatric side effects were more common with esketamine (45.1% vs 22.0%) but were transient and resolved without drug treatment.
BMJ (Clinical research ed.)
July 8, 2024
Cecilia Njenga, Parashar Pravin Ramanuj, Frederico Jose Coelho De Magalhães et al.
44 citations
Major depressive disorder (MDD) affects many people, but its underlying causes remain unclear. Treatment resistance points to the disorder's heterogeneity and the need for therapies beyond monoamine neurotransmission. This review examines emerging targets for MDD, including psychedelics, antibiotics, opioid modulators, neuropeptides, and onabotulinumtoxin, as well as neuromodulatory treatments like light-based therapies, magnetic stimulation, and electrical stimulation. Most interventions were tested as add-ons to antidepressants. Research on psychedelics is most advanced, with trials suggesting rapid antidepressant and anti-suicidal effects. The review considers trial findings, tolerability, study design limitations, and research quality. Currently, forming recommendations is challenging, but future research may allow more robust guidance.