Novel Approaches for Managing Depression

Successfully treating patients with major depression often is a trial-and-error process. When a series of standard drug therapies or drug combinations are unsuccessful — either because they aren't sufficiently effective or because of unacceptable adverse effects — patients and clinicians might be motivated to try less-conventional approaches. In 2023, randomized trials of several such approaches were published in major medical journals, as follows:

• Ketamine can have antidepressant effects (as well as sedative, analgesic, and anesthetic effects) but also can cause dissociative reactions and hallucinations. In a multicenter trial, 365 patients with treatment-resistant depression received 3-week courses of either twice-weekly intravenous ketami…