Psychopharmacology Bulletin
August 12, 2025
Alan F. Schatzberg, D Charles
15 citations
Several innovative psychiatric drugs have recently been approved or are nearing approval. Auvelity (bupropion/dextromethorphan) speeds antidepressant response and remission more than bupropion alone. Zuranolone, a 14-day oral treatment for postpartum depression, improves symptoms at day 15 and through day 45. Gepirone, a 5HT1a partial agonist, was approved for major depression based on positive trials and a favorable side effect profile. Cariprazine was approved as an adjunctive treatment for resistant major depression at 1.5 mg daily. MDMA-assisted psychotherapy for PTSD led to over 70% of subjects no longer meeting PTSD criteria, compared to 46% with psychotherapy and placebo. Xenomeline/tropsium (KarXT), a muscarinic M1M4 agonist, effectively treats positive and negative schizophrenia symptoms without dopamine antagonism. Lecanemab, a monoclonal antibody targeting beta-amyloid, slowed cognitive decline by 27% in early Alzheimer's disease.
Psychopharmacology Bulletin
August 12, 2025
Dustin Latimer, Michael D. Stocker, Kia Sayers et al.
10 citations
Post-traumatic stress disorder (PTSD) is common among U.S. veterans. Standard treatments include trauma-focused psychotherapies and antidepressant medications such as SSRIs and SNRIs. MDMA, a psychoactive compound classified as a Schedule I controlled substance since the 1980s, has reemerged as a potential therapy. Before prohibition, psychotherapists used it for various psychiatric conditions. Recent randomized, controlled trials support MDMA as an effective pharmacological adjunct to psychotherapy for PTSD.
Psychopharmacology Bulletin
August 12, 2025
Priyanka Ghosh, Omar Viswanath
1 citation
A CNN article described a man with a 35-year history of severe refractory depression and suicidal ideation who was successfully treated with ketamine after failing numerous other medications. Seven placebo-controlled randomized clinical trials have shown beneficial effects of ketamine infusion therapy for refractory depression. However, ketamine therapy remains limited as an off-label use, with no large-scale randomized controlled trials demonstrating its safety or durability. Patient selection criteria are limited to major depressive disorder without psychotic features, with effects lasting up to one week. Evidence suggests other patients and repeated dosing could be beneficial, but clinical trials are lacking, and the FDA has not approved ketamine for psychiatric illness.
Psychopharmacology Bulletin
August 12, 2025
Anna Mori-Kreiner, Arpit Aggarwal, Meelie Bordoloi
1 citation
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 stay. Treatment with aripiprazole 5 mg led to gradual symptom improvement, though symptoms did not fully resolve. Literature review indicates first-line treatments include clonidine and benzodiazepines; second-generation antipsychotics are generally less effective except aripiprazole. Diagnosis was complicated by polysubstance use, requiring distinction from non-substance-induced psychotic disorders.
Psychopharmacology Bulletin
August 12, 2025
Patrick J Beck, Abhishek Reddy
An adolescent female presented to the emergency department with acute psychosis after using a cannabis vape pen. Her symptoms were self-limited and resolved without significant intervention, leading to a diagnosis of cannabis-induced psychosis (CIP). Cannabis vaping is growing in popularity among adolescents due to ease of concealment and lack of odor, and vape products often contain higher THC concentrations than traditional cannabis leaf, potentially increasing the risk for adverse effects including dysphoria and psychosis. The case is used to discuss CIP symptomatology and treatment, and the broader implications of cannabis vaping for adolescent neurodevelopment, substance use, and psychiatric comorbidities.