Brief app-based mindfulness and socio-emotional dyadic interventions improved depression, anxiety, emotion regulation, and stress recovery only among people who had shown resilient stress-reactivity profiles during the COVID-19 pandemic. Those with vulnerable profiles—characterized by less plasticity in stress recovery—did not improve on any outcome. The findings come from 253 community adults who used a daily 12-minute app for 10 weeks with weekly coaching. The results suggest that low-dose digital mental interventions may benefit individuals with greater stress resiliency, while more vulnerable individuals may need more intensive or personalized approaches.
For 70 years depression treatment was limited by the monoamine hypothesis until the approval of the S-enantiomer of ketamine, an NMDA receptor blocker with rapid antidepressant and antisuicidal effects. Dextromethorphan, another NMDA receptor antagonist, has also been approved for depression in combination with bupropion. The GABA-A receptor modulator brexanolone has shown relatively rapid antidepressant efficacy. However, clinical utility is compromised by high drug costs, mandatory monitoring requirements, parenteral administration, lack of insurance coverage, COVID-19 effects on healthcare systems, and psychopharmacology training gaps. This narrative review analyzes the clinical pharmacology of recently approved antidepressants and barriers to bench-to-bedside translation. Overall, meaningful advances have not reached many depressed patients, including those with treatment-resistant depression who might benefit most.