Brain stimulation
January 1, 2024
Charles R Conway, Scott T Aaronson, Harold A Sackeim et al.
16 citations
Patients with treatment-resistant unipolar major depressive disorder who qualified for the RECOVER trial—the largest randomized sham-controlled study of vagus nerve stimulation for a psychiatric condition—had severe disability, a median of 11.0 prior failed antidepressant treatments, and high rates of suicidality (77% with suicidal ideation, 40% with previous suicide attempts). Seventy-one percent had received at least one prior interventional psychiatric treatment (electroconvulsive therapy, transcranial magnetic stimulation, or esketamine). Compared to those without such history, recipients of interventional treatments were younger, more severely depressed, had greater suicidal ideation, earlier onset of depression, and more failed medication trials.
American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics
June 17, 2025
Clio E Franklin, Murat Altinay, Kala Bailey et al.
2 citations
For treatment-resistant mood disorders, intensive interventions such as electroconvulsive therapy, transcranial magnetic stimulation, ketamine, and esketamine are commonly used, but how genetics influences response to these therapies remains unclear. A review of the current literature finds that most studies have examined single variants in candidate genes, particularly COMT and BDNF, yet none have been consistently reproducible. Genome-wide association studies are few and mostly underpowered, with only one exceeding 1000 participants, yielding few statistically significant single nucleotide polymorphisms outside COMT and BDNF. Large-scale data collection is needed to establish genetic predictors and differentiate responses among treatments, a goal being pursued by the worldwide Gen-ECT-ic consortium.
Current opinion in anaesthesiology
August 1, 2018
Scott C Tadler, Brian J Mickey
Several anesthetic drugs show promise as novel antidepressants for treatment-resistant depression. Ketamine has acute, transient antidepressant and antisuicidal effects. Nitrous oxide has also shown antidepressant efficacy. Converging preclinical and clinical data indicate that isoflurane (and perhaps propofol), dosed to burst suppression, produces relatively rapid, robust, and durable antidepressant effects without the adverse cognitive effects associated with electroconvulsive therapy (ECT). Ketamine is the most well-studied among them. Anesthetic-induced burst suppression may offer an alternative to ECT. Further study is needed to understand how these drugs work and how they might be used effectively.