Journal of Psychopharmacology | 2021
The Journal of Psychopharmacology: La Plus ça change. . .
Abstract
This edition of the Journal marks a transition from the editorship of Professor Dave Nutt to my own. Professor Nutt will become “Editor Emeritus” and will continue to be involved with the Journal in that capacity. It is with great humility that I take over from Dave and I can only hope that we will continue the fine work that he has delivered over his tenure as Editor. Professor Pierre Blier will continue to serve as Co-Editor, and I am most grateful to Pierre for his willingness to continue in this role. Pierre and I are also planning to hold discussions with the Editorial Board as to how we might best review their roles in the Journal and make appropriate changes for the future. We both agree that an active and engaged Editorial Board is very important for the well-being of the Journal, and we thank all Board members for their service in the past and future. I would also like to take this opportunity to thank Dr Pallab Seth for his outstanding contribution as Managing Editor of the Journal. Pallab will be continuing in this role and undoubtedly will continue to play a vital role. The contents of this edition of the Journal aptly cover the topics, which have been and will continue to be of interest to our readers in the future and cover a broad swathe of psychopharmacology and concern many important issues, which greatly impact human health (Fineberg et al. 2013). Vázquez et al. (2021) report an interesting study on combined treatments for major depression. They reviewed randomized, placebo-controlled trials and found that several modern antipsychotics and esketamine appeared to be useful adjuncts to antidepressants for acute major depressive episodes. However, lithium was somewhat more effective and better tolerated. Most trials of adding lithium involved older, mainly tricyclic, antidepressants, and the dosing of adjunctive treatments was not optimized. Their findings encourage clinical consideration of lithium as an adjunct in the treatment of major depression. Yanhong He and colleagues carried out a study and aimed at systematically examining evidence on the efficacy of antidepressants in the treatment of depression in patients with Alzheimer’s disease (AD). Their research shows that sertraline and mirtazapine showed a slightly better effect in treating symptoms of depression in AD patients and propose that they should be used as a first-line treatment (He et al., 2021). However, more high-quality trials with large samples and longer follow-up are proposed. Danilo Arnone and colleagues conducted a review of double-blind randomized controlled studies investigating the use of onabotulinumtoxinA compared to placebo in the treatment of major depression. The meta-analysis supported the efficacy of the intervention, but results were highly heterogeneous across studies. More research is required to better understand those heterogeneous factors and the role of onabotulinumtoxinA in the treatment of depression (Arnone et al., 2021). Marilia Gougoulaki and colleagues report a secondary analysis of whether the selective serotonin reuptake inhibitor (SSRI), citalopram, was more effective in women compared with men. However, women and men had similar prognosis after the SSRI treatment and similar prognosis regardless of antidepressant class (Gougoulaki et al., 2021). Their findings were not unaltered by menopausal status. Buster Mannheimer and colleagues investigated the detailed time course of SSRIassociated hyponatremia. They found a dramatically increased risk of hyponatremia exclusively related to newly initiated treatment (Mannheimer et al., 2021). They suggest that, even subtle symptoms consistent with hyponatremia during the first weeks of SSRI treatment should prompt analysis of sodium levels. In patients treated with SSRIs for several months or years, other causes should be sought in the event of hyponatremia. Emma Kopra and colleagues conducted an interesting systematic review, investigating ketamine’s therapeutic mechanisms. They report that its anti-inflammatory properties and subsequent downstream effects on tryptophan metabolism have sparked research interest (Kopra et al., 2021). They suggest future research including an investigation of markers in the central nervous system and examination of clinical relevance of inflammatory changes. Rachael Sumner and colleagues conducted qualitative interviews looking at the psychedelic experiences and sustained impact of ketamine in patients with major depressive disorder (MDD). This study provided preliminary evidence for the role of the psychedelic experience and afterglow in ketamine’s antidepressant properties (Sumner et al., 2021). Furthermore, there may be a rationale for psychotherapeutic guidance as part of ketamine therapy for MDD, as well as greater attention to the context in which ketamine is administered. A number of these effects are not captured by quantitative measures of depression alone. Reflexive thematic analysis provided a wealth of information on participants’ experience of the study and demonstrate that the psychedelic properties of ketamine are The Journal of Psychopharmacology: La Plus ça change. . .