[Interventional psychiatric procedures and novel substances for the treatment of affective disorders: An overview and outlook].
Tobias Bracht, Daniela Hubl, Kristina Adorjan, Gianluca Florineth, Leila M Soravia, Bogdan Draganski, Sebastian Olbrich, Annette Brühl, Niklaus Denier
Therapeutische Umschau. Revue therapeutique April 1, 2025 DOI: 10.23785/TU.2025.02.005 via PubMed
Summary
AI-generated from the abstractFor patients with difficult-to-treat depression who do not respond to at least two antidepressant trials, remission rates are significantly lower than the 67% seen with initial or secondary pharmacological treatment. Brain stimulation procedures and novel substances offer innovative and effective options to complement standard therapies. This overview covers repetitive transcranial magnetic stimulation, electroconvulsive therapy, ketamine/esketamine, transcranial direct current stimulation, deep brain stimulation, and psychedelic-assisted psychotherapy, with an outlook on individualized, procedure-specific indications.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | repetitive transcranial magnetic stimulation electroconvulsive therapy ketamine/esketamine transcranial direct current stimulation deep brain stimulation psychedelic-assisted psychotherapy |
| Topics | Depression |
| Keywords | Electroconvulsive therapy ect Ketamine/esketamine Depression therapy innovations Neuromodulation treatments |
| Citations | 1 |
| Key finding | For patients with difficult-to-treat depression, brain stimulation procedures and novel substances represent innovative and effective treatment options that complement pharmacotherapy and psychotherapy. |
Abstract
Depression is one of the most common mental disorders. The effectiveness of pharmacological and psychotherapeutic treatments is well documented. Remission rates are around 67 % for pharmacological antidepressant initial and secondary treatment of a depressive episode in unipolar disorders. However, patients with a depressive episode who do not respond to at least two successive attempts at pharmacological antidepressant treatment have significantly lower remission rates. Particularly in this subgroup with difficult-to-treat depression, brain stimulation procedures and treatment with novel substances represent innovative and effective treatment options that complement pharmacotherapy and psychotherapy. The aim of this paper is to provide an overview and outlook on the following treatment procedures: repetitive transcranial magnetic stimulation (rTMS), electroconvulsive therapy (ECT), ketamine/esketamine, transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and psychedelic-assisted psychotherapy (PAT). An outlook on selected current developments with the aim of a procedure-specific, individualized indication will be given.