A Delphi panel of 60 Italian psychiatrists found wide variation in how treatment-resistant depression (TRD) is managed in Italy, highlighting a need for standardized strategies and treatments specifically approved for TRD. High consensus emerged on adding lithium or antipsychotics as augmentation therapies and on the need for long-term maintenance therapy. Esketamine nasal spray was identified as the best option for TRD patients, with agreement that it can be administered in a community outpatient setting given appropriate educational support for patients.
A review of research into MDMA-assisted psychotherapy for treatment-resistant PTSD found that small-scale studies show reduced psychological trauma, but there is widespread misunderstanding that MDMA itself is a treatment for PTSD, which has not been researched. This misunderstanding leads to harmful media reporting and impedes research. The authors conclude that MDMA-assisted psychotherapy may help people who have not resolved their problems through existing treatments, but more research is needed, and accurate reporting is essential.