Medicina (Kaunas, Lithuania)
March 21, 2025
Keming Gao, Evrim Bayrak Oruc, Buket Koparal
9 citations
Monoamine-based antidepressants, including SSRIs, SNRIs, bupropion, TCAs, mirtazapine, and agomelatine, show similar efficacy relative to placebo but differ in acceptability. The STAR*D study found sertraline, venlafaxine, and bupropion equally effective after citalopram failure. Dextromethorphan-bupropion, ketamine, and esketamine act faster but with effect sizes similar to monoamine drugs. Brexanolone and zuranolone are effective for postpartum depression, though zuranolone's effect in major depressive disorder is very small. Psychedelics show rapid, large, and durable effects but await phase III confirmation. NMDA receptor antagonists and neurosteroids may gain importance, while monoamine-based drugs likely remain mainstream.
Medicina (Kaunas, Lithuania)
April 23, 2024
Beatriz Manarte Pinto, Isaura Tavares, Daniel Humberto Pozza
6 citations
A systematic review of 26 randomized controlled trials found that mindfulness-based therapies and guided imagery (GI) can help manage chronic non-cancer pain. Mindfulness techniques significantly reduced pain intensity in six trials and improved non-sensory dimensions of pain (such as emotional distress) in ten trials. GI produced significant pain reduction in three trials and improved non-sensory outcomes in two trials. Four mindfulness trials reported significant reductions in opioid consumption, while one GI trial found a small effect. The review highlights Mindfulness-Oriented Recovery Enhancement (MORE) as a particularly promising approach for improving interoception. Most studies had moderate to high risk of bias.
Medicina (Kaunas, Lithuania)
April 11, 2024
6 citations
Among 236 residents of long-term care homes in Thailand (mean age 73.5 years, 57.6% female), 58.4% engaged in meditation from often to daily. Meditation moderated the relationship between insecure attachment and loneliness. For attachment anxiety, the interaction with meditation was significant, indicating that meditation's effect on loneliness depends on attachment style. The direction of effects varied by attachment dimension, suggesting meditation may help some residents more than others depending on their attachment patterns.
Medicina (Kaunas, Lithuania)
December 12, 2024
David W Orme-Johnson, Vernon A Barnes, Brian Rees et al.
5 citations
All categories of meditation helped reduce PTSD symptoms, with Transcendental Meditation (TM) producing significantly larger reductions than other types. A meta-analysis of 61 studies with 3,440 subjects compared four meditation approaches: Mindfulness-Based Stress Reduction, other mindfulness techniques, Transcendental Meditation, and other non-mindfulness, non-TM methods. TM's effect size (Hedges's g = -1.13) was significantly larger than the others, which ranged from -0.52 to -0.66 and did not differ from each other. Trauma populations included war veterans, refugees, earthquake and tsunami victims, survivors of interpersonal violence, nurses, and prison inmates. No serious side effects were reported. A Phase 3 clinical trial testing TM against standard treatment was recommended.
Medicina (Kaunas, Lithuania)
June 26, 2025
Filipa Ćavar Mišković, Goran Milas
4 citations
Trait mindfulness is strongly linked to lower depressive symptoms in adolescents, acting through both direct and indirect pathways. Analyzing longitudinal data from 3,897 adolescents across four waves, mindfulness showed a strong negative correlation with depression (r = -0.39 to -0.56). The direct effect on reducing depression was substantial (β = -0.60 to -0.74), while indirect effects via cognitive reappraisal were smaller (β = -0.10 to -0.26 for stress reduction; up to -0.17 for depression). These indirect effects varied modestly across different types of stressful life events. The findings suggest mindfulness protects against adolescent depression primarily through direct cognitive-emotional processes, with additional benefit from more adaptive stress appraisal.
Medicina (Kaunas, Lithuania)
August 5, 2024
Nuray Camgoz Eryilmaz, Mustafa Arslan, Aysegul Kucuk et al.
3 citations
In elderly rats with streptozotocin-induced Alzheimer's disease, repeated administration of ketamine, propofol, or their combination improved cognitive performance on the radial arm maze test compared to untreated Alzheimer's rats. Ketamine and the ketamine-plus-propofol group showed improvement after the first anesthesia, while propofol alone improved after the second. The treatments also reduced oxidative stress markers (lower TBARS, higher catalase and paraoxonase-1 activity) and lessened histopathological changes in brain tissue. Apoptosis-related protein expression shifted favorably, with decreased caspase-3 in the combination group. The results suggest that repeated anesthesia can positively affect cognitive functions in this Alzheimer's model.
Medicina (Kaunas, Lithuania)
October 30, 2024
Piangdao Sripunya, Tinakon Wongpakaran, Nahathai Wongpakaran
2 citations
Feelings of emptiness are a key driver of self-harm in borderline personality disorder, but inner strengths such as adherence to the Five Precepts, meditation practice, and equanimity can weaken that link. In a study of 302 Thai adults with BPD symptoms, a mediation analysis showed that these inner strengths significantly reduced the direct effect of emptiness on self-harm, with the model explaining 38% of the variance in self-harm. The indirect effect through inner strengths was small but statistically significant, suggesting that cultivating these qualities may help buffer against self-harm by addressing underlying emotional difficulties.
Medicina (Kaunas, Lithuania)
April 22, 2024
Onur Küçük, Esra Sarı, Musa Zengin et al.
2 citations
A low dose of intravenous ketamine (0.15 mg/kg) given three minutes before thoracic epidural catheterization reduces both pain and anxiety during the procedure more than a placebo. Among sixty patients randomly assigned to either ketamine or placebo, those receiving ketamine reported, on average, 9 mm lower pain scores and 10.6 mm lower anxiety scores on 100 mm visual analog scales during catheter insertion. More patients in the ketamine group did not recall the procedure and would consent to it again. Pain scores remained stable in the ketamine group, while they rose in the placebo group. The dose caused no significant side effects on breathing, blood pressure, or mental state.
Medicina (Kaunas, Lithuania)
April 15, 2025
Yong-Bum Joo, Young-Mo Kim, Woo-Yong Lee et al.
1 citation
Postoperative delirium after total knee arthroplasty is linked to lower scores on Life's Simple 7, a measure of cardiovascular health. In a retrospective study of 973 patients, those who developed delirium had significantly lower Life's Simple 7 scores. A score of 8 or less identified patients at risk with 92% sensitivity and 58% specificity. The measure may help predict delirium and guide preoperative risk assessment.
Medicina (Kaunas, Lithuania)
April 3, 2025
David W Orme-Johnson, Vernon A Barnes, Brian Rees et al.
1 citation
A systematic review and meta-analysis of 15 controlled trials on the Transcendental Meditation (TM) technique for treating PTSD, involving 1,248 participants across civilian and military populations, found that TM produced a large reduction in PTSD symptoms compared to other treatments (effect size g = -1.01). TM worked as well as prolonged exposure therapy but significantly faster, showing benefits by week six. The effects were consistent across age, sex, and military or civilian status, with no single study reducing the overall effect. The authors recommend larger phase-III trials comparing TM with established first-line PTSD treatments.
Medicina (Kaunas, Lithuania)
June 3, 2024
Keming Gao
1 citation
A patient with treatment-resistant bipolar depression who had limited benefit from electroconvulsive therapy (stopped due to memory concerns) and ketamine infusion (tolerated but little benefit) responded well to deep repetitive transcranial magnetic stimulation (dTMS). After 39 sessions of dTMS, the patient maintained relative stability for more than 2 years. This case suggests that dTMS may benefit patients with treatment-resistant bipolar depression who have not responded to or cannot continue ECT or ketamine infusion.
Medicina (Kaunas, Lithuania)
January 15, 2026
Ömer Emgin, Gamze Taşkan, Aytuğ Yıldız et al.
Among 130 intensive care unit patients, 47.7% experienced peri-intubation cardiovascular collapse (PIC). Age Shock Index (Age-SI) had the highest predictive accuracy for PIC. Ketamine was associated with a reduced risk of PIC (odds ratio 0.161), while propofol (odds ratio 2.962), older age, higher lactate, and higher Diastolic Shock Index were independent risk factors. ICU mortality was markedly higher in patients who developed PIC (74.2% vs. 20.6%). These findings support using Age-SI and other shock indices for risk assessment and selecting ketamine over propofol to lower PIC risk during ICU intubation.
Medicina (Kaunas, Lithuania)
November 20, 2025
Martin Leurent, Déborah Ducasse
Third-wave cognitive-behavioral therapies have shifted focus from symptom reduction to process-based change, with self-identification as a core dimension. The Self-Identification Program (SIP) targets dysfunctional self-identification—the reification of transient mental contents as defining features of a self—by integrating mindfulness, loving/kindness and compassion, and deconstructive insight into the nature of self. SIP aligns with dimensional psychiatry and behavioral linguistics, bridging contextual behavioral science and contemplative practice. It offers a unified, process-based model of identity transformation that extends beyond mindfulness and compassion training to address how mistaken identification with an independent self becomes a source of suffering, providing a mechanistically grounded pathway for enduring change in depressive and bipolar spectrum disorders.