Psychiatry and Clinical Neurosciences Reports
March 1, 2025
Alessandro Serretti
11 citations
Anhedonia, a reduced ability to experience pleasure, is a symptom that cuts across many mental disorders and is linked to poor treatment outcomes. This narrative review surveys interventions that target anhedonia, including medications such as vortioxetine, agomelatine, bupropion, ketamine, and brexpiprazole, which show promising anti-anhedonic effects, while traditional antidepressants like SNRIs and SSRIs are less effective. Neuromodulation techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and transcutaneous auricular vagus nerve stimulation, improve anhedonia when applied to targeted brain areas. Psychotherapeutic approaches such as behavioral activation, mindfulness, and savoring techniques help patients re-engage with pleasurable activities. Emerging treatments like aticaprant and psilocybin also show promise. Improving anhedonia is linked to better psychosocial functioning, quality of life, and sustained remission, supporting routine assessment and tailored intervention strategies.
Psychiatry and Clinical Neurosciences Reports
December 1, 2024
Itsuki Terao, Wakako Kodama
Intravenous racemic ketamine, psilocybin, and theta burst stimulation (TBS) all outperformed placebo for major depressive disorder in a network meta-analysis of 28 randomized controlled trials. Ketamine and psilocybin showed significantly greater antidepressant effects than TBS, with no differences in tolerability or acceptability compared to placebo. In periods of 1 week or less, only ketamine was significantly more effective than placebo. In periods of 4 weeks or longer, both ketamine and psilocybin were significantly better than placebo. Confidence in the evidence ranged from very low to moderate due to limited studies, especially for psilocybin, and a lack of direct comparison trials. These preliminary findings suggest ketamine and psilocybin may be more effective than TBS, with ketamine possibly offering faster onset.
Psychiatry and Clinical Neurosciences Reports
May 16, 2024
Shunichiro Ikeda, Toshihiko Kinoshita
After a period of prohibition following 1960s abuse, clinical research on psychedelics has resumed since the 1990s, revealing rapid and sustained therapeutic effects. Cannabidiol, ketamine, MDMA, and psilocybin show promise for depression and PTSD, with potential benefits for postpartum depression and PMDD. A Phase II trial enrolling 59 patients with moderate to severe MDD found that psilocybin and escitalopram both reduced depression scores at six weeks, with no significant difference in efficacy, though psilocybin improved symptoms within hours and persisted for months. Ketamine's antidepressant effects were first demonstrated in a double-blind, placebo-controlled study with seven subjects.