Top 10 Findings of Past Year: Treatment Resistant Depression and Benzos
Oct 14, 2024
auto_awesome
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.
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.
Insights on Benzodiazepine Withdrawal
A retrospective review involving over 200,000 patients revealed surprisingly higher mortality rates among those who stopped long-term benzodiazepine use compared to those who continued. While the non-randomized nature of the study invites scrutiny, the findings persisted even after adjusting for major confounding factors. The authors suggest that the challenges and miseries faced during benzodiazepine withdrawal could lead to increased risk behaviors and adverse health outcomes. These results highlight the necessity for healthcare providers to consider the risks associated with withdrawal equally alongside the potential harms of continued benzodiazepine use.
Long-Term Use of Benzodiazepines
A large-scale study conducted in Denmark provided reassurance regarding long-term benzodiazepine use, indicating that chronic use is rare, with only a small percentage of users remaining on the medication beyond three years. This investigation showed that, among those who started benzodiazepines, dose escalation was uncommon, especially in the absence of a substance use history. While these findings are encouraging, caution is advised as they may not be universally applicable outside Denmark. The study reinforced the importance of monitoring patients carefully, particularly those with a history of substance use disorders, to prevent potential issues with escalation or prolonged reliance on the medications.
Chris Aiken and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode