New treatments for mood disorders Flashcards
What is the most recent drug to be approved for use in Depression and how does it work?
Ketamine: Dissociative drug
Quick onset, effective against suicidality
NMDA antagonist
How is Ketamine administered and how long does it last?
Nasal, intravenously, intramuscularly, Subcutaneously, oral
Lasts: 10-14 days
What are the limitations to Ketamine?
Difficult to placebo Lack of negative side-effect reports Potential for abuse Lack of long term responses Maintaining response
Which Psychedelics are being studied for depression?
Psilocybin:
Phase 1 study: Healthy individuals broadly safe
RCT in Depression are positive
Ayahuasca and DMT
Still in phase 1 for healthy people
Non-RCT shows promise
How could psilocybin be better than Ketamine?
Effects last longer than 2 weeks
No addiction issue
What issues exist for psilocybin?
Bi-polar not tested
Placebo issue like ketamine
Skewed samples as those who have positive experience more likely to volunteer.
Costly as psychotherapy is needed before and after.
How effective has Repetitive transcranial magnetic stimulation been?
It is approved in the UK, delivers an electric pulse into brain and neural tissue
Only 50% effective, 25 % remitting
No side effects long term
Unknown response durability
What is Transcranial direct current stimulation?
Low amplitude current applied via electrodes to brain areas close to the surface.
Similar to DBS and VNS (not allowed in the UK)
What are four ways to treat peripheral symptoms of depression?
Anti-inflamatory interventions:
Particularly good with inflammatory depression
some evidence in treating mania-not replicated
Cognitive and Functional enhancement:
Interpersonal and social rhythms: stabilises circadian rhythms.
Suicide focused: Ketamine, DBT, lithium, ECT (example of RDOC treating issue not illness)
