Expert review of neurotherapeutics
June 1, 2023
Harry A Fagan, David S Baldwin
55 citations
Generalized Anxiety Disorder (GAD) is common and characterized by excessive worry. Current treatments include pharmacological and psychological options, but many patients do not respond to first-line drugs. This review covers diagnostic criteria, epidemiology, and effective medications such as duloxetine, escitalopram, pregabalin, quetiapine, and venlafaxine. It also discusses treatment guidelines, management of treatment resistance, and special considerations for older adults and children. Evidence for further pharmacological management after initial treatment failure is limited. Many novel anxiolytics have entered clinical trials, but translation from animal models has mostly been unsuccessful. Compounds including certain psychedelics, ketamine, oxytocin, and agents modulating the orexin, endocannabinoid, and immune systems show potential for further study.
Expert review of neurotherapeutics
January 1, 2022
Manaswini Pillai, Simon Erridge, Lara Bapir et al.
27 citations
Patients prescribed cannabis-based medicinal products for post-traumatic stress disorder showed significant improvements in PTSD symptoms, sleep, and anxiety at 1, 3, and 6 months, based on an analysis of 162 patients from the UK Medical Cannabis Registry. Most patients (88.89%) had previously or currently used cannabis. Median daily doses were 5.00 mg of cannabidiol and 145.00 mg of Δ9-tetrahydrocannabinol. Adverse events occurred in 20.37% of patients, with 135.8% of the total events reported; most were mild or moderate, and insomnia and fatigue were most common. The findings suggest acceptability and safety up to 6 months, but randomized placebo-controlled trials are needed to confirm causality and optimal dosing.
Expert review of neurotherapeutics
April 1, 2025
Stefania Chiappini, Gaia Sampogna, Antonio Ventriglio et al.
17 citations
Depression involves a wide range of emotional, cognitive, and physical symptoms that disrupt daily life. Societal changes such as technological advances, economic pressures, climate change, and shifting cultural norms have altered how depression appears and is understood, leading to the identification of new depression subtypes. These include depression in adolescents and young adults, depression with social disconnection, depression with alcohol or substance use disorder, depression with gender dysphoria, and depression linked to stressful events and environmental factors. Managing these subtypes requires individualized treatment approaches. While SSRIs and SNRIs remain standard, atypical antidepressants like trazodone, ketamine, neuromodulation, and personalized psychotherapy offer hope for complex or treatment-resistant cases.
Expert review of neurotherapeutics
June 1, 2025
Rosalie Girard Pepin, Fatemeh Seyfzadeh, David Williamson et al.
7 citations
Pharmacological treatment options for disorders of consciousness (DoC), which range from coma to minimally conscious state, remain limited due to the heterogeneity of causes such as traumatic brain injury, stroke, and infections. A lack of rigorous clinical trials has led to off-label use of drugs—including dopaminergic and GABAergic agents, antidepressants, statins, and anticonvulsants—often without clear mechanistic understanding. Robust longitudinal trials are needed, prioritizing early subacute intervention and better-defined outcomes that consider immediate responses and long-term quality of life. A shift toward personalized medicine and unified functional frameworks is advocated, along with increased use of AI tools to predict treatment responses.
Expert review of neurotherapeutics
January 1, 2023
Emmanuelle A. D. Schindler, Peter S. Hendricks
5 citations
Most current psychedelic research targets depression and substance use disorders, but reports also indicate benefits for headache disorders and chronic pain. This perspective reviews conventional treatments for these conditions and describes historical, recent, and ongoing investigations of psychedelics' therapeutic effects, including the first two clinical trials of psilocybin in headache disorders and case reports of psilocybin mushroom self-administration in chronic pain patients. It highlights challenges when applying the standard psychedelic-assisted psychotherapy model—featuring larger doses, emphasis on subjective effects, and required adjunctive psychotherapy—to headache and chronic pain disorders. Flexibility in protocols is needed to evaluate different treatment paradigms and mechanisms.
Expert review of neurotherapeutics
February 1, 2025
Donatella Marazziti, Francesco Weiss, Riccardo Gurrieri et al.
4 citations
After decades of neglect, psychedelics are again being studied for clinical use, but the current enthusiasm risks overstating their benefits and downplaying their harms. The authors review the literature to give a balanced account of both therapeutic potential and risks. Psychedelics show promise for many conditions and appear to have limited risk of abuse or dependence when given under controlled conditions by trained staff. However, many questions remain, and more research is needed to identify which patients and conditions will benefit and which face greater risk of adverse effects.
Expert review of neurotherapeutics
July 1, 2026
Stephen Rush, Henry A Nasrallah
Treatment-resistant depression may stem from impaired neural adaptability rather than a simple chemical imbalance. This expert review synthesizes research showing a shift from monoamine-based models of depression toward frameworks centered on neuroplasticity, synaptic growth, glutamatergic signaling, and brain network dysfunction. The authors describe how treatments such as ketamine, neuromodulation, and psychedelics may work by reopening windows of plasticity and recalibrating dysfunctional neural networks, representing a paradigm shift in antidepressant development. The review is a conceptual synthesis, not treatment guidelines, and prospective studies are needed to validate and apply these mechanistically informed models clinically.