The Carlat Psychiatry Podcast cover image

The Carlat Psychiatry Podcast

Top 10 Findings of Past Year: Treatment Resistant Depression and Benzos

Oct 14, 2024
Discover the latest breakthroughs in treating resistant depression, including the promising role of Transcranial Magnetic Stimulation (TMS) compared to traditional methods. Explore the alarming statistics on mortality rates linked to benzodiazepine withdrawal, highlighting severe risks for discontinuing users. The discussion also covers the emotional complexities of withdrawal, emphasizing compassion in care. Finally, learn about insights from a long-term study that stresses careful management during benzodiazepine tapering.
19:34

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Quick takeaways

  • Transcranial magnetic stimulation (TMS) has shown superior effectiveness for treatment-resistant depression, outperforming alternatives after multiple treatment failures.
  • A study indicated higher mortality rates during benzodiazepine withdrawal, highlighting the need for careful management of withdrawal risks.

Deep dives

Updates on Treatment-Resistant Depression

Recent studies have emphasized the effectiveness of transcranial magnetic stimulation (TMS) for treatment-resistant depression (TRD). Two major trials found that TMS outperformed alternative strategies such as switching antidepressants and augmenting existing treatments with aripiprazole. Notably, TMS achieved a meaningful difference when compared to switching antidepressants after patients had failed at least two previous treatments. Despite the promising results, limitations such as the lack of blinding and the funding circumstances of the trials raise questions about the robustness of the conclusions.

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