Journal of Psychopharmacology最新文献

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The goal of specificity in psychotropic drug development: A lesson from Sisyphus? 精神药物开发的特异性目标:西西弗斯的教训?
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-09 DOI: 10.1177/02698811261443683
David Nutt
{"title":"The goal of specificity in psychotropic drug development: A lesson from Sisyphus?","authors":"David Nutt","doi":"10.1177/02698811261443683","DOIUrl":"https://doi.org/10.1177/02698811261443683","url":null,"abstract":"","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443683"},"PeriodicalIF":5.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of pharmacological and nutritional interventions for glucose dysfunction in schizophrenia-A systematic review and network meta-analysis. 药物和营养干预对精神分裂症患者葡萄糖功能障碍的疗效:系统评价和网络荟萃分析。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-09 DOI: 10.1177/02698811261443680
Chun-I Liu, Lu-Wen Lin, Yuan-Jen Tsai, Mong-Liang Lu, Chenyi Chen, Kah Kheng Goh
{"title":"Efficacy of pharmacological and nutritional interventions for glucose dysfunction in schizophrenia-A systematic review and network meta-analysis.","authors":"Chun-I Liu, Lu-Wen Lin, Yuan-Jen Tsai, Mong-Liang Lu, Chenyi Chen, Kah Kheng Goh","doi":"10.1177/02698811261443680","DOIUrl":"https://doi.org/10.1177/02698811261443680","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with schizophrenia experience disproportionately high rates of impaired glucose tolerance and insulin resistance. While pharmacological strategies have demonstrated efficacy, concerns about polypharmacy and drug-drug interactions highlight the need to evaluate alternative approaches.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, Web of Science, and CENTRAL up to February 10, 2025, for randomized controlled trials assessing pharmacological or nutritional interventions on metabolic outcomes in schizophrenia. Eligible trials reported fasting blood glucose, HbA1c, serum insulin, or Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Secondary outcomes included anthropometrics, lipid profiles, and psychopathology (Positive and Negative Syndrome Scale). Data were synthesized using Bayesian network meta-analysis with random-effects, and treatments were ranked using surface under the cumulative ranking curve. Risk of bias was assessed with RoB 2.</p><p><strong>Results: </strong>A total of 102 RCTs including 7278 participants were analyzed. For fasting glucose, topiramate, synbiotic, vitamin E, and probiotic/selenium were beneficial. Metformin improved insulin levels and HOMA-IR, while aripiprazole showed significant improvement in HbA1c. Secondary outcomes revealed reductions in body mass index and body weight with aripiprazole, liraglutide, metformin, nizatidine, sibutramine, topiramate, zonisamide, and berberine. Lipid improvements were observed with aripiprazole, liraglutide, pioglitazone, pravastatin, sitagliptin, topiramate, berberine, synbiotic, and Withania somnifera. Evidence for most nutritional supplements was limited and heterogeneous.</p><p><strong>Conclusions: </strong>This study provides the first integrated comparison of pharmacological and nutritional interventions for glucose dysfunction in schizophrenia. Metformin showed the most consistent benefits, whereas aripiprazole, topiramate, liraglutide, and select supplements demonstrated additional advantages. These findings highlight the importance of targeting glucose dysregulation as a core therapeutic priority and support the cautious but promising role of nutritional agents alongside established pharmacological strategies.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443680"},"PeriodicalIF":5.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oxytocin prevents ketamine-induced executive control deficits in macaque monkeys. 催产素可以防止氯胺酮引起的猕猴执行控制缺陷。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-07 DOI: 10.1177/02698811261443678
Elahe Rohani, Fatemeh Mohtashami Borzadaran, Marzieh Mowlavi Vardanjani, Sadegh Ghasemian, Vahid Sheibani, Farshad A Mansouri
{"title":"Oxytocin prevents ketamine-induced executive control deficits in macaque monkeys.","authors":"Elahe Rohani, Fatemeh Mohtashami Borzadaran, Marzieh Mowlavi Vardanjani, Sadegh Ghasemian, Vahid Sheibani, Farshad A Mansouri","doi":"10.1177/02698811261443678","DOIUrl":"https://doi.org/10.1177/02698811261443678","url":null,"abstract":"<p><strong>Background: </strong>Ketamine, an <i>N</i>-methyl-<i>D</i>-aspartate (NMDA) receptor antagonist, has gained attention for its rapid antidepressant effects at subanesthetic doses. However, its potential for overdose and cognitive side effects, especially after misuse, remains a concern. The impact of ketamine on inhibitory control, a critical component of executive function, is not well understood. Oxytocin, a neuropeptide involved in emotional regulation and social cognition, may modulate cognitive functions, but its interaction with ketamine, particularly in relation to inhibitory control, remains unclear.</p><p><strong>Aims: </strong>This study aimed to investigate the effects of ketamine on inhibitory control and explore whether oxytocin could mitigate these effects in a macaque monkey model.</p><p><strong>Methods: </strong>In experiment 1, macaque monkeys (<i>N</i> = 4) received intramuscular ketamine (0.25, 0.5, or 1.0 mg/kg) or saline before performing the stop-signal task. In experiment 2, the 1.0 mg/kg ketamine dose was selected to assess whether intranasal oxytocin (50 IU) pretreatment could attenuate ketamine-induced cognitive impairments.</p><p><strong>Results: </strong>Ketamine significantly impaired response inhibition and execution in a dose-dependent manner, with the greatest deficits at 1.0 mg/kg. Oxytocin pretreatment significantly restored inhibitory control, normalizing stop-signal reaction time to levels comparable to the saline control condition.</p><p><strong>Conclusions: </strong>These findings suggest that low-dose ketamine disrupts executive control in non-human primates, and that oxytocin may counteract these effects, particularly in inhibitory control. This interaction highlights a promising therapeutic pathway for executive dysfunction in neuropsychiatric disorders.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443678"},"PeriodicalIF":5.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular mortality and depression: A systematic review and meta-analysis of the association with antidepressant treatment and co-morbidity. 心血管死亡率和抑郁症:与抗抑郁治疗和合并症相关的系统回顾和荟萃分析。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-07 DOI: 10.1177/02698811261433212
Tiago da Silva Costa, Beth Hall, Sean Hill, Ramy Teama, Eleanor Romaine, Sharmin Ahmed, Iain McKinnon, Stuart Watson, Alan Bagnall, Ryan Kenny, Richard Hamish McAllister-Williams
{"title":"Cardiovascular mortality and depression: A systematic review and meta-analysis of the association with antidepressant treatment and co-morbidity.","authors":"Tiago da Silva Costa, Beth Hall, Sean Hill, Ramy Teama, Eleanor Romaine, Sharmin Ahmed, Iain McKinnon, Stuart Watson, Alan Bagnall, Ryan Kenny, Richard Hamish McAllister-Williams","doi":"10.1177/02698811261433212","DOIUrl":"https://doi.org/10.1177/02698811261433212","url":null,"abstract":"<p><strong>Background: </strong>Depression is associated with increased mortality, with underlying causes unclear. We conducted a systematic review and meta-analysis of cardiovascular (CV) mortality in depression and how antidepressant treatments and comorbidities modify this.</p><p><strong>Methods: </strong>We searched Medline, Embase, Scopus, Web of Science and Cochrane registers (inception to 31 December 2024) for randomised controlled trials (RCTs) and observational studies comparing CV mortality in adults with depression vs without, and receiving antidepressants vs controls. We excluded studies with <12 months follow-up, reporting only all-cause mortality or lacking control groups. Random-effects meta-analyses were conducted with CV mortality as the primary outcome. Risk of bias was assessed with RoB 2 and ROBINS-I.</p><p><strong>Prospero: </strong>CRD42020200812.</p><p><strong>Results: </strong>We included 7 RCTs and 47 cohort studies (1,593,722 people). In multivariable-adjusted cohorts (<i>k</i> = 26), depression was associated with a significantly higher CV mortality versus no-depression (hazard ratio (HR): 1.45, 95% CI: 1.25-1.69). Effects were similar in non-selected community-dwelling cohorts and those with CV disease or type 2 diabetes. Antidepressants overall were associated with increased CV mortality in cohorts but after adjustment only tricyclic antidepressants (TCAs) had significantly increased risk vs no antidepressant (<i>k</i> = 4; HR: 1.27, 95% CI: 1.02-1.58). RCT findings were directionally consistent but underpowered.</p><p><strong>Conclusions: </strong>Depression is associated with increased risk of CV mortality irrespective of comorbid group studied. Antidepressants do not appear to modify this risk, apart from TCAs, which may increase it. The antidepressant models in particular had high heterogeneity, reflecting a knowledge gap on the long-term effects of antidepressants in patients with depression on CV mortality.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261433212"},"PeriodicalIF":5.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of benzodiazepines on saccadic eye movements: A systematic review and meta-analysis. 苯二氮卓类药物对跳跃性眼球运动的影响:系统回顾和荟萃分析。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-04 DOI: 10.1177/02698811261436602
Pia-Magdalena Schmidt, Philine Margarete Baumert, Kaja Faßbender, Ulrich Ettinger
{"title":"Effects of benzodiazepines on saccadic eye movements: A systematic review and meta-analysis.","authors":"Pia-Magdalena Schmidt, Philine Margarete Baumert, Kaja Faßbender, Ulrich Ettinger","doi":"10.1177/02698811261436602","DOIUrl":"https://doi.org/10.1177/02698811261436602","url":null,"abstract":"<p><p>Benzodiazepines are commonly prescribed psychotropic drugs with anxiolytic, sedating, hypnotic, and anticonvulsant effects. They impair saccadic eye movements in prosaccade tasks, particularly peak velocity, but the extent of the effects on different saccadic parameters remains unclear. Therefore, we conducted a systematic review and meta-analyses on the effects of different benzodiazepines on peak velocity (<i>k</i> (number of included studies) = 30, <i>k</i><sub>ES</sub> (number of included effect sizes) = 45, <i>N</i> (number of participants) = 444), latency (<i>k</i> = 12, <i>k</i><sub>ES</sub> = 17, <i>N</i> = 221) and amplitude gain (<i>k</i> = 5, <i>k</i><sub>ES</sub> = 8, <i>N</i> = 113). Furthermore, we performed meta-analyses and dose-dependent meta-regressions of lorazepam effects on peak velocity (<i>k</i> = 13, <i>k</i><sub>ES</sub> = 19, <i>N</i> = 257) and latency (<i>k</i> = 8, <i>k</i><sub>ES</sub> = 12, <i>N</i> = 187). We found a robust and large effect on peak velocity (standardised mean change (SMCC)) = -1.064, 95% CI (confidence intervals) [-1.287, -0.84]), a less consistent, medium sized effect on latency (SMCC = 0.706, 95% CI [0.285, 1.127]), and a medium sized, but non-significant, effect on gain (SMCC = -0.581, 95% CI [-1.226, 0.064]). These findings confirm the sensitivity of saccadic eye movements to modulation of gamma-aminobutyric acid (GABA) through benzodiazepines and point to the peak velocity in particular as a biomarker for sedative effects in pharmacological research in healthy adults.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261436602"},"PeriodicalIF":5.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of psychedelic use on authoritarian attitudes revisited. 致幻剂使用对权威态度的影响。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-02 DOI: 10.1177/02698811261443677
Otto Simonsson, Taylor Lyons, Joseph Marks, Hannes Kettner, Leor Roseman, Eline Haijen, Mendel Kaelen, Robin Carhart-Harris
{"title":"Effects of psychedelic use on authoritarian attitudes revisited.","authors":"Otto Simonsson, Taylor Lyons, Joseph Marks, Hannes Kettner, Leor Roseman, Eline Haijen, Mendel Kaelen, Robin Carhart-Harris","doi":"10.1177/02698811261443677","DOIUrl":"https://doi.org/10.1177/02698811261443677","url":null,"abstract":"<p><strong>Background: </strong>Previous research suggests that psychedelics may, under certain conditions, decrease authoritarian attitudes, but larger and more rigorously designed studies are needed to confirm these findings.</p><p><strong>Aims: </strong>We aimed to examine the effects of psychedelic use on authoritarian attitudes.</p><p><strong>Methods: </strong>Using data from three separate studies with different designs and populations, we investigated the relationship between psychedelic use and authoritarian attitudes. Study 1 was a naturalistic observational study with participants who planned to use psychedelics at their own initiative, Study 2 was a single-arm study with healthy volunteers who received psilocybin, and Study 3 was a randomized, controlled trial with patients diagnosed with depression who received psilocybin or escitalopram.</p><p><strong>Results: </strong>Across the three studies, results showed no significant changes in authoritarian attitudes after psychedelic use.</p><p><strong>Conclusions: </strong>Contrary to previous research, the latest evidence is not compelling that psychedelic use influences authoritarian attitudes in a reliable direction. Future research should recruit larger and more diverse samples, collect additional context-related data, and also investigate political outcomes other than authoritarian attitudes.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443677"},"PeriodicalIF":5.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
5-HT1A receptor blockade potentiates the subjective effects of DMT. 5-HT1A受体阻断可增强DMT的主观效应。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-05-02 DOI: 10.1177/02698811261443696
Zarmeen Zahid, Rick J Strassman, Clifford R Qualls, Sandeep M Nayak
{"title":"5-HT<sub>1A</sub> receptor blockade potentiates the subjective effects of DMT.","authors":"Zarmeen Zahid, Rick J Strassman, Clifford R Qualls, Sandeep M Nayak","doi":"10.1177/02698811261443696","DOIUrl":"https://doi.org/10.1177/02698811261443696","url":null,"abstract":"<p><strong>Introduction: </strong>Serotonergic psychedelics are being investigated in the treatment of various disorders and in the improvement of well-being. Evidence suggests that their subjective effects may play a role in long-term behavioral outcomes. The subjective effects are mediated by 5-HT<sub>2A</sub> receptor agonism, but the 5-HT<sub>1A</sub> receptor may also play a role in the subjective effects. This study elucidates the effects of 5-HT<sub>1A</sub> receptor blockade using pindolol pre-treatment on the subjective effects induced by <i>N,N</i>-dimethyltryptamine (DMT).</p><p><strong>Methods: </strong>In a double-blind, randomized, placebo-controlled within-subjects design, 12 (10 males, 2 females) experienced hallucinogen-using participants received a sub-hallucinogenic dose of intravenous DMT fumarate, 0.1 mg/kg, after pre-treatment with 30 mg oral racemic pindolol. Subjective effects were measured using the Hallucinogen Rating Scale.</p><p><strong>Results: </strong>Pindolol pre-treatment increased DMT-induced subjective effects with a moderate effect size (<i>M</i> = 0.514). Blood pressure and mean arterial pressure also increased with pindolol pre-treatment at 2 minutes following DMT administration, but heart rate was not affected.</p><p><strong>Conclusions: </strong>5-HT<sub>1A</sub> receptor blockade results in a global intensification of DMT-induced subjective effects, suggesting a functional role of 5-HT<sub>1A</sub> receptor action in the mechanism of psychedelic-induced subjective effects.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443696"},"PeriodicalIF":5.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preliminary evidence that serum interleukin-6 is a candidate biomarker of response to esketamine in treatment-resistant depression. 初步证据表明血清白细胞介素-6是难治性抑郁症患者对艾氯胺酮反应的候选生物标志物。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-04-24 DOI: 10.1177/02698811261443676
Marco Colizzi, Elisa Morandin, Veronica Croccia, Claudia Scipioni, Chiara Rosada, Orietta Sepulcri, Matteo Balestrieri, Marco Garzitto
{"title":"Preliminary evidence that serum interleukin-6 is a candidate biomarker of response to esketamine in treatment-resistant depression.","authors":"Marco Colizzi, Elisa Morandin, Veronica Croccia, Claudia Scipioni, Chiara Rosada, Orietta Sepulcri, Matteo Balestrieri, Marco Garzitto","doi":"10.1177/02698811261443676","DOIUrl":"https://doi.org/10.1177/02698811261443676","url":null,"abstract":"<p><strong>Background: </strong>Interleukin-6 (IL-6) has been implicated as a potential predictor of ketamine response in treatment-resistant depression (TRD). Esketamine, the S-enantiomer of ketamine, produces rapid antidepressant effects and offers improved safety and intranasal administration.</p><p><strong>Objective: </strong>To examine whether baseline IL-6 predicts treatment response to esketamine in individuals with TRD.</p><p><strong>Methods: </strong>Fourteen adults with TRD received intranasal esketamine twice weekly for 4 weeks, followed by a tapering phase, in a 24-week open-label Phase 2 trial. Depression severity and functional disability were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and World Health Organization Disability Assessment Schedule at baseline, week 8, and week 24. Serum IL-6 levels were measured at the same time points. Linear mixed-effects models were used to evaluate the predictive value of IL-6.</p><p><strong>Results: </strong>MADRS scores improved significantly over time. Higher IL-6 levels were associated with more rapid symptom reduction, whereas lower IL-6 predicted greater symptom severity and higher disability. IL-6 levels did not change significantly over the course of treatment.</p><p><strong>Conclusions: </strong>Baseline IL-6 may predict response to esketamine in TRD, highlighting the potential role of inflammation in treatment resistance and supporting biomarker-guided personalized interventions.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261443676"},"PeriodicalIF":5.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effects of the PDE4 inhibitor roflumilast on cognitive performance after a cerebrovascular accident: a double-blind randomized placebo-controlled trial with an open label extension (ROSTMEMA). PDE4抑制剂罗氟司特对脑血管意外后认知表现的影响:一项开放标签扩展(ROSTMEMA)的双盲随机安慰剂对照试验
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-04-24 DOI: 10.1177/02698811261436581
Jill Kerckhoffs, Ieke Winkens, Arthur Ooghe, Samuel Branders, Jos Prickaerts, Arjan Blokland
{"title":"The effects of the PDE4 inhibitor roflumilast on cognitive performance after a cerebrovascular accident: a double-blind randomized placebo-controlled trial with an open label extension (ROSTMEMA).","authors":"Jill Kerckhoffs, Ieke Winkens, Arthur Ooghe, Samuel Branders, Jos Prickaerts, Arjan Blokland","doi":"10.1177/02698811261436581","DOIUrl":"https://doi.org/10.1177/02698811261436581","url":null,"abstract":"<p><strong>Background: </strong>Effective pharmacological treatments for Post-Stroke Cognitive Impairment (PSCI) remain elusive. Preclinical studies have shown that phosphodiesterase 4 (PDE4) inhibition improved cognition, particularly memory, in post-stroke animal models and in healthy young and elderly individuals. This study tested whether the PDE4 inhibitor roflumilast could improve memory in PSCI patients.</p><p><strong>Methods: </strong>A double-blind randomized placebo-controlled trial (RCT) included 100 community-dwelling participants receiving roflumilast (100 µg q.d.) or placebo (<b><i>N</i></b> = 50 per group). Participants were 41-70 years and had suffered a cerebrovascular accident more than a year ago. They had subjective memory complaints and scored below the normative score on the delayed recall of the verbal learning test (VLT). After the RCT, 42 placebo group participants completed a 3-month open label extension (OLE). The primary outcome was the VLT delayed recall score. Roflumilast efficacy in the RCT was estimated through analysis of covariance (ANCOVA) with (post hoc) and without adjustment for baseline prognostic covariates defined a priori. In the OLE, general linear model repeated measures analyses were used. Secondary outcomes related to cognition, mood, and daily functioning.</p><p><strong>Results: </strong>Of the 97 participants completing the study (roflumilast: 48; placebo: 49), primary ANCOVA indicated a larger response in the roflumilast group on VLT and Rivermead Behavioural Memory Test (stories) at endpoint with non-significant moderate effect sizes (Cohen's <b><i>d</i></b>: 0.31-0.36). When post hoc adjusting for prognostic baseline covariates, effect sizes (0.33-0.40) became significant. Adverse events were similar in both groups. In the OLE, all memory test scores improved with medium to large significant effect sizes (Partial η<sup>2</sup>: 0.079-0.171).</p><p><strong>Conclusions: </strong>Roflumilast appeared to improve memory and was not associated with adverse effects. Results support further clinical studies.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261436581"},"PeriodicalIF":5.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of average time-to-relapse following ECT versus ketamine - A systematic review. 电痉挛治疗与氯胺酮治疗后平均复发时间的比较——一项系统评价。
IF 5.5 3区 医学
Journal of Psychopharmacology Pub Date : 2026-04-16 DOI: 10.1177/02698811261430502
Minna Chang, Allan H Young, Mario F Juruena
{"title":"Comparison of average time-to-relapse following ECT versus ketamine - A systematic review.","authors":"Minna Chang, Allan H Young, Mario F Juruena","doi":"10.1177/02698811261430502","DOIUrl":"https://doi.org/10.1177/02698811261430502","url":null,"abstract":"<p><strong>Background: </strong>Previous systematic reviews and meta-analyses have reported impressive antidepressant effects of ketamine in treatment-resistant depression (TRD). While ketamine has been compared with electroconvulsive therapy (ECT), the gold standard treatment, the extent and durability of its antidepressant effects over longer periods remain unclear. To our knowledge, this is the first systematic review comparing average time-to-relapse between ECT and ketamine in TRD.</p><p><strong>Aims: </strong>To compare the average time-to-relapse between ECT and ketamine for TRD.</p><p><strong>Method: </strong>We conducted this systematic review using PubMed, Medline, ScienceDirect, Cochrane Library, Ovid, PsycNET, Embase and Google Scholar, against predetermined criteria.</p><p><strong>Prospero id: </strong>CRD42025643824.</p><p><strong>Results: </strong>Thirteen studies met inclusion criteria: 10 examined ketamine/(s)ketamine, and 3 focused on ECT. Twelve were randomised controlled trials (RCTs), and one was retrospective. Heterogeneity was observed in dosing regimens and administration schedules, with some studies having limited follow-up and small sample sizes. Findings are synthesised narratively. In summary, there is evidence for sustained therapeutic potential of both ECT and ketamine, ECT possibly being associated with longer remission. Increased dose, frequency and use of maintenance ECT/ketamine appear to prolong remission, and continuing oral antidepressants may prolong this further. It should also be noted that this review excluded studies involving psychotic depression, leading to the exclusion of some head-to-head studies, thus limiting the generalisability of the findings in these populations.</p><p><strong>Conclusion: </strong>There is currently a lack of studies within our inclusion criteria that directly compare time-to-relapse after ECT and ketamine, preventing formal statistical analysis. More high-quality, large-scale RCTs directly comparing these treatment modalities with longer follow-up times are needed.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811261430502"},"PeriodicalIF":5.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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