Ketamine for severe depression: what can we conclude from a small open label study?

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Last week the media reported widely on a study of ketamine for depression (McShane et al, 2014). As usual the headlines made bold assertions, the Telegraph running with “Horse tranquilliser Ketamine could cure severe depression” (Knapton, 2014). But what did the paper authored by an Oxford group and published in the Journal of Psychopharmacology really [read the full story…]

Recent review suggests Agomelatine is as effective as other antidepressants, but controversy persists

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In spite of widely available different antidepressants, major depression does not respond adequately in up to one third of patients. Overall, the need for both reliable and well-tolerated treatment has remained unmet for a sizeable proportion of people with depression. In the past couple of years, there has been controversy about the suitability of Agomelatine (Valdoxan) [read the full story…]

Little differences among antidepressants regarding sexual dysfunction, but bupropion performs best

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Antidepressant treatment is associated with a variety of side effects, including emotional changes, weight gain or fatigue. As pharmaceutical treatment has evolved, clinicians have become increasingly aware of another major adverse effect of modern antidepressants: sexual dysfunction. Current figures estimate that up to every second patient will, at some stage, experience reduced sexual function, which [read the full story…]

Is treatment for depression cost-effective in people with diabetes?

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There is evidence to suggest that people with diabetes are twice as likely to suffer from depression. It’s therefore important that the cost-effectiveness of treatments for comorbid depression be indentified. The elves have already reported on a review of the effectiveness of collaborative care for people with diabetes and depression, suggesting that the intervention might be effective. While [read the full story…]

Largest RCT so far suggests that ketamine may be useful in the acute treatment of refractory depression

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Major depression is a serious mental illness that often does not respond to mainstream drug treatment (antidepressants). In addition, there is usually a delay of 2-6 weeks before mood improves significantly. In situations like this, when at least two conventional antidepressants have been tried without success, depression is considered treatment-resistant. While multiple different strategies to [read the full story…]

Better together: how collaborative working can improve outcomes for patients with depression and diabetes

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The link between depression and diabetes mellitus (DM) is well established. Around 20% of patients with DM meet diagnostic criteria for depression. The National Institute for Health and Care Excellence (NICE) issued guidance impressing the importance of diagnosing and treating depression in long-term conditions such as DM (NICE, 2009). However, depression in the presence of [read the full story…]

Mood management can improve smoking cessation in patients with past and current depression

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There is a high rate of co-morbidity between depression and smoking; rates of smoking are approximately double in those with depression compared with the general population. In addition, smokers with depression tend to have higher rates of nicotine dependence, suffer greater negative affect during abstinence/withdrawal, are more likely to fail in quit attempts, and are [read the full story…]

Systematic review highlights a lack of evidence about using antidepressants to treat cancer patients with depression

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Having a life threatening disease such as cancer and undergoing gruelling treatment can have detrimental psychological effects. According to a recent review, for instance, the prevalence of depression among cancer patients is 10.8%, when assessed by a standardised clinical assessment (Ng et al. 2011). The authors of this meta-analysis make the argument that established criteria [read the full story…]

New Cochrane review finds weak evidence that drug combinations are more effective than monotherapy in psychotic depression

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Major depression remains a serious condition that often proves refractory to pharmacological or psychotherapeutic interventions. Because depression can have many “faces”, clinicians should be aware of the great symptom variability among depressed patients and consider subforms when prescribing medication.  In a sizeable amount of patients (up to 25%, Coryell et al., 1984), depression presents with [read the full story…]

Cost-effectiveness of St John’s wort for treatment of depression

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Herbal medicines often represent a cheaper alternative, or a low-cost complement, to standard pharmacotherapy. As a result, improved cost-effectiveness is often touted as a likely benefit of the use of complementary and alternative medicine (CAM). Many, myself included, have been openly critical of CAM research, while others have suggested ways in which CAM research could [read the full story…]