Dual Therapy for Depression; Ties Between Illicit Drug Use and Youth Suicidality
— A round-up of noteworthy research from the American Psychiatric Association meeting
by Kristen Monaco, Staff Writer, MedPage Today May 26, 2022
NEW ORLEANS — The American Psychiatric Association (APA) annual meeting included news on adjunctive cariprazine (Vraylar) for depression, a potential paradigm shift for mental healthcare delivery, and harnessing telepsychiatry for schizophrenia patients on long-acting injectables.
Below are a few more APA research highlights.
Best Combo for Depression?
Adults with major depressive disorder saw the biggest drop in Montgomery-Åsberg Depression Rating Scale (MADRS) score when treated with a combination of esketamine nasal spray (Spravato) plus an oral antidepressant.
This treatment combo had a 9.16-point greater improvement in total score compared with those treated with an atypical antipsychotic and an oral antidepressant, according to a meta-analysis of 12 studies.
Additionally, the bigger drops in depression severity rating with esketamine in comparison to aripiprazole (Abilify) and brexpiprazole (Rexulti) were apparent as early as the first week of treatment.
At week 1, esketamine-treated patients had a 1.71 and 2.05-point greater drop in total MADRS score than treatment with both antipsychotics, respectively.
However, all treatment combinations did show an improvement in depressive symptoms.
The meta-analysis included 2,565 patients treated with atypical antipsychotics or esketamine plus an antidepressant, and 1,711 patients on an antidepressant alone. Esketamine trials lasted 4 weeks, while the atypical antipsychotic trials included lasted 6 to 12 weeks.
« The mechanistically different adjunctive or conjunctive antidepressant agents (esketamine or atypical antipsychotics) appear to differ in their antidepressant outcomes, » Guang Chen, MD, PhD, of Janssen Research & Development in San Diego, and colleagues wrote in an APA poster.
Youth Suicidality and Drug Use
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