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New and emerging treatments for major depressive disorder.

Cecilia NjengaParashar Pravin RamanujFrederico Jose Coelho de MagalhãesHarold Alan Pincus
Published in: BMJ (Clinical research ed.) (2024)
Major depressive disorder (MDD) affects a substantial portion of the population; however, much is still unknown about the pathophysiology of this disorder. Treatment resistance highlights the heterogeneous nature of MDD and the need for treatments to target more than monoamine neurotransmission. This review summarizes research into the new and emerging targets of MDD. These include drugs such as psychedelics, antibiotics, opioid modulators, neuropeptides, and onabotulinumtoxin. Neuromodulatory treatments such as light based therapies and neuromodulation involving either magnetic or electrical stimulation are also discussed. Almost all interventions, pharmacological and neuromodulation, were trialed as adjunctive treatments to an antidepressant. Most research has been conducted on psychedelics, with trials suggesting rapid antidepressant and anti-suicidal effects. Trial findings, tolerability, study design limitations and quality of research have been considered throughout this review. There remains challenges in forming recommendations with the current research at present. With there being considerable interest into the research of new and emerging treatments-in particular, psychedelics-there may be scope in the future to form more robust recommendations.
Keyphrases
  • major depressive disorder
  • bipolar disorder
  • clinical trial
  • spinal cord injury
  • depressive symptoms
  • chronic pain
  • open label
  • current status
  • molecularly imprinted
  • combination therapy
  • simultaneous determination