International journal of psychiatry in clinical practice
July 10, 2025
Stefan Jerotic, Milica Nestorovic, Janko Nesic et al.
3 citations
In two male patients with treatment-resistant depression, a structured interview assessing their felt sense of time (TATE) detected improvements in subjective experience before a standard depression rating scale (MADRS) did. One patient's TATE scores reached general population levels at week 4, one week earlier than the MADRS indicated treatment response. These cases suggest that phenomenological assessments can capture nuanced early improvements that traditional scales may miss, offering a complementary tool for monitoring treatment effectiveness.
International journal of psychiatry in clinical practice
June 1, 2024
Ludovic Samalin, Lila Mekaoui, Pierre De Maricourt et al.
3 citations
An observational study of adults with treatment-resistant depression (TRD) treated with esketamine across three time periods found that patients had moderate-to-severe depression, with an average Montgomery-Åsberg Depression Rating Scale score of 32.6. The 157 treated patients (average age 49.0 years, 66.2% female) showed varied disease severity, subtypes, and comorbidities across cohorts. Later cohorts used esketamine earlier and before other treatments. The findings indicate a high burden of TRD and suggest esketamine is a potentially useful alternative, especially as clinicians gain more familiarity and access.
International journal of psychiatry in clinical practice
June 1, 2026
Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc et al.
Women made up 62.9% of participants across 13 esketamine clinical trials for mental health disorders, while men comprised 37.1%. The racial distribution showed White participants at 69.08%, Asian at 13.31%, Black or African American at 3.60%, American Indian or Alaska Native at 0.08%, and Native Hawaiian or Other Pacific Islander at 0.04%. Hispanic or Latino representation ranged from 10.57% to 11.02% due to reporting discrepancies in one trial. These trials demonstrate significant racial and ethnic disparities, with underrepresentation of minority groups, highlighting the need for regulatory efforts to improve diversity and fair representation in future research.
International journal of psychiatry in clinical practice
April 29, 2026
David Eckert, Siegfried Kasper
A narrative review presents a decision-making framework for three pharmacological augmentation strategies for treatment-resistant depression: lithium, quetiapine, and esketamine. The agents differ in pharmacological profile, monitoring requirements, and clinical application, though their mechanisms appear to converge on neuroplasticity pathways. Treatment selection may be guided by psychiatric presentation, somatic comorbidity, and practical feasibility. Validated predictive markers for differential response are currently lacking.
International journal of psychiatry in clinical practice
February 7, 2026
Daniel Pustay, Vishal Patel, Krista Ulisse et al.
A systematic review of 42 studies examined predictors of response to electroconvulsive therapy, repetitive transcranial magnetic stimulation, and ketamine-based treatments in adults with treatment-resistant depression. Predictive factors were grouped into clinical (symptom profile, illness duration), biological (IL-6, CRP, BDNF), and imaging (cingulate cortex activity, connectivity) categories. Inflammation markers and fronto-limbic network findings appeared across treatments but were inconsistent. Some predictors show promise, but clinical use remains limited by methodological differences and small sample sizes. Larger and comparative studies are needed to identify clinically useful predictors for treatment decision-making.
International journal of psychiatry in clinical practice
January 1, 2024
M Spies, S Kasper, R Frey et al.
Modern electroconvulsive therapy (ECT) and ketamine are the most effective treatments for depressed patients who do not respond to two or more antidepressants. Recent large head-to-head comparisons of intravenous ketamine versus ECT for treatment-resistant depression have produced conflicting findings, largely because of major differences in patients' baseline characteristics and treatment procedures across studies. This commentary argues that treatment decisions between ECT and ketamine should rely on predictive clinical response markers and patient preferences, not on direct comparisons that are methodologically limited. It also emphasizes that since ketamine is usually given before ECT, future studies should examine ECT's effectiveness specifically in patients who did not respond to ketamine.