Sexual side effects on SSRIs are so common that psychiatrist David Healy once argued these drugs more reliably lower libido than treat depression. Yet the problem isn’t limited to SSRIs, and it’s not unmanageable.

You may have been hearing a lot of buzz about vortioxetine (Trintellix) and cognition. The FDA recently allowed a labeling change with this antidepressant that mentions specific benefits in cognitive symptoms of depression. Depressed patients tell us all the time how bad their memory is, and their concerns are valid.

Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsible, but other NMDA antagonists have not worked well in depression.

Treatment-resistant depression (TRD) has a fairly low barrier of entry. Failure of 2 full antidepressant trials—lasting 6 weeks at a minimally effective dose—is enough to qualify. In this month’s issue of TCPR, we’ll highlight pharmacologic advances that are underutilized and debunk a few that are unlikely to be effective for TRD.

You may have read about the meta-analysis published in Lancet earlier this year on the efficacy evidence for all antidepressants (Cipriani A et al, Lancet 2018;391(10128):1357–1366). It’s a complicated paper, and in this article, we’ll take a closer look at it and give you our take on the bottom line.

Over the last decade, several published studies have reported an increased risk of type 2 diabetes associated with antidepressant use in adults. But does the same hold true for children and adolescents?

There’s a lot of discussion in the medical journals about nutritional psychiatry, which is the concept that certain diets can prevent or treat psychiatric disorders (Marx W et al, Proc Nutr Soc 2017;76(4):427-436).