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12 papers
Researchers are testing many ways to help people who feel low energy or low motivation, often as part of treating depression. The clearest, strongest evidence right now is for ketamine and its close relative esketamine. These drugs can reduce depressive symptoms quickly for some people who did not get better with usual medicines. Regular physical activity, especially walking, also has good evidence for reducing depressive symptoms and may help energy over time. Other approaches look promising but are still early-stage. Psychedelic-assisted psychotherapy (drugs like psilocybin or MDMA given together with careful therapy) shows encouraging results in trials but needs more research and detailed therapy support. Brain-based treatments such as deep brain stimulation (DBS) or combining brain stimulation with ketamine are experimental but may help some people who have not responded to many other treatments. Whole-body hyperthermia (controlled heating) is very preliminary and needs careful testing and safety checks. Across all options, safety, careful preparation, and close follow-up are important because effects and risks vary between people.
Researchers tested a single intravenous dose of ketamine in 73 people with major depression that had not gotten better with usual treatments. In a two-site, double-blind trial, people were randomly given either ketamine or an active placebo (the anesthetic midazolam). Twenty-four hours after the infusion, people who got ketamine were…
Researchers tested a nasal spray form of esketamine together with a newly started oral antidepressant in adults whose depression had not improved after trying at least two antidepressants. Over four weeks, people who got esketamine plus a new antidepressant had faster and larger drops in depression symptoms than those who…
A group of international mood-disorder experts reviewed the research on ketamine and esketamine for adults whose depression did not get better with usual antidepressants. They found that these drugs work differently from standard antidepressants and can lift symptoms more quickly for some people with treatment-resistant depression. However, the experts also…
Treatment-resistant depression means depression that does not get better after usual treatments. Scientists do not all agree on one clear definition, which makes it hard to know exactly how common it is or which treatments work best. Using the definition that regulators often use, about 30% of people with depression…
This paper is a careful review of research about treatment-resistant depression. The authors looked through medical studies to see how doctors define this kind of depression, what makes it hard to assess, and which treatments have been tried. They describe drug strategies like adding lithium or thyroid hormone, switching antidepressant…
The CANMAT 2023 update gives doctors clear, up-to-date advice for treating adults with major depressive disorder. It puts evidence into a practical, clinician-friendly format. The update says treatment should be a team effort between patients and clinicians, be tailored to each person, and follow a planned, systematic process with regular…
This review explains how ketamine can lift depression symptoms much faster than standard antidepressants. Researchers describe the clinical results, how doctors usually give ketamine, and the brain changes it seems to cause. They also say that the treatment must be given carefully because small dose changes matter, the exact brain…
Researchers tested repeated subcutaneous (under-the-skin) injections of racemic ketamine in people whose depression had not improved after at least two antidepressant trials. People got injections twice a week for 4 weeks and neither participants nor the raters knew which drug they were getting. When the study allowed higher, response-guided ketamine…
This paper reviews what scientists know about how ketamine and classic serotonergic psychedelics (like psilocybin and LSD) can lift depression quickly. The authors compare how the drugs work in the brain, point out that ketamine has the strongest clinical evidence so far, and say psychedelics show early promise but need…
Major depressive disorder is a serious illness. Researchers reviewed how ketamine — a drug that blocks a brain receptor called the NMDA receptor — can lift depression symptoms quickly and for a sustained time in people and in animals. They describe possible ways ketamine works: it may boost another type…
This paper reported a small, randomized trial of 64 people with treatment-resistant major depression who were given a single intravenous dose of ketamine or a saline placebo. The authors said depression and suicidal thoughts dropped quickly — within an hour — and that benefits lasted up to two months, but…
This paper reviewed past studies to figure out why many people gain weight while taking antidepressants and what can be done about it. The authors found that about 55–65% of people on long-term antidepressants can gain weight, that different drugs carry different risks, and that the weight changes come from…
