Hope for Neurotic Disorders: A Summary of New Zealand Research on the Development of Biomarkers and Novel Treatments.

Neurotic disorders such as depression, anxiety, and PTSD are diagnosed by symptoms rather than biological causes, making them costly and difficult to treat. Researchers in New Zealand have developed an EEG biomarker for anxiety disorders that can detect resistance to conventional treatments, with similar work underway for depression. Ketamine has been identified as a novel treatment for treatment-resistant neurotic disorders, supported by a proposed "double hit" hypothesis of its mechanisms. Similar results have been obtained with ketamine, LSD, and psilocybin, and treatment-related EEG changes have been demonstrated. These developments, potentially combined with psychotherapy, may lead to faster, broader, and more effective treatments, especially with the recent development of oral tablet delivery for home dosing.

Study at a glance

Abstract

The neurotic disorders (e.g., depression, dysthymia, generalized anxiety disorder, panic disorder, agoraphobia, social anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder) are costly and difficult to treat. Diagnosis is based on symptoms not biological causes. Here, we summarize New Zealand-based work developing EEG biomarkers and novel treatments. Working at the University of Otago, we have developed an anxiety disorder biomarker and shown its potential to detect anxiety resistant to conventional treatments. Others have started similar work on depression biomarkers. We have also found that ketamine is a novel treatment for treatment-resistant neurotic disorders in general and have provided a "double hit" hypothesis of the mechanisms involved. Muthukumaraswamy and coworkers at the University of Auckland and elsewhere have obtained similar results with ketamine, LSD, and psilocybin, and we, along with them, have demonstrated treatment-related effects on EEG. These linked developments, potentially supplemented with psychotherapy, should open the way to quicker acting, broad ranging, effective treatment of neurotic disorders. With the our recent more purely practical development of oral tablet delivery, which will allow home dosing, the future for the treatment of neurotic disorders looks bright.