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Benefits of Meditation and Yoga in Clinically Depressed Patients
Published in Anne George, Snigdha S. Babu, M. P. Ajithkumar, Sabu Thomas, Holistic Healthcare. Volume 2: Possibilities and Challenges, 2019
Madhuri Tolahunase, Rajesh Sagar, Rima Dada
Novel approaches are being considered, which improve neuroplasticity and other biological mechanisms. Parenteral or intranasal administration of the glutamatergic drugs ketamine or esketamine, which are antagonists of N-methyl-d-aspartate.Intravenous scopolamine.The opioid modulator ALKS 5461.
Key considerations in the pharmacological management of treatment-resistant depression
Published in Expert Opinion on Pharmacotherapy, 2021
Mani Yavi, Ioline D. Henter, Lawrence T Park, Carlos Zarate
There has been considerable interest in the opioid system as a target for novel therapeutic agents, given its involvement in mood regulation and incentive salience [51]. Furthermore, numerous studies have demonstrated that the opioid partial agonist buprenorphine has antidepressant effects [52]. However, a recent meta-analysis of randomized, placebo-controlled trials evaluating its use as an augmentation strategy in TRD found that buprenorphine did not reduce the severity of depressive symptoms compared to placebo [53]. Building on this work, two multi-center, placebo-controlled, Phase 3 trials investigating combination treatment with buprenorphine/samidorphan (BUP/SAM), an investigational opioid modulator known as ALK 5461, found that adjunctive use of this agent was superior to placebo in reducing Montgomery-Åsberg Depression Rating Scale (MADRS) scores in TRD patients at a dose combination of 2 mg/2 mg in the second study (FORWARD-5 (n = 407)) as well as in a pooled analysis of both studies [54]. Although ALK 5461 was well-tolerated, the FDA has not approved the drug for MDD, and more clinical data are needed to clarify its therapeutic efficacy.
Current and emerging systemic treatments targeting the neural system for chronic pruritus
Published in Expert Opinion on Pharmacotherapy, 2020
Rachel Shireen Golpanian, Gil Yosipovitch
Therapeutic strategies reducing neural sensitization are important treatments as neural sensitization plays a substantial role in chronic itch of different types. As such, it is not surprising that novel drugs which work by reducing neural sensitization (i.e. kappa-opioid agonists, NK-1 inhibitors) have proven to be quite helpful in clinical trials. The most promising targeted treatment which seems to be very close to marketplace consumption is the opioid modulator difelikefalin, which has shown great success in reducing uremic pruritus and seems to be devoid of major side effects. Similarly, nalbuphine is emerging as an opioidergic targeted treatment for prurigo nodularis. Although NK-1 and substance P play a significant role in chronic itch and are overexpressed in pruritic skin diseases, serlopitant and tradipitant which showed initial promise did not achieve their primary endpoints in phase III clinical trials. It is therefore my prediction that these drugs will not launch in the marketplace in the near future unless higher efficacy is established.
Emerging drugs for the treatment of L-DOPA-induced dyskinesia: an update
Published in Expert Opinion on Emerging Drugs, 2020
Sohaila AlShimemeri, Susan H Fox, Naomi P Visanji
Nalbuphine, is a mixed agonist/antagonist opioid modulator with moderate-efficacy partial agonist or antagonist of the μ-opioid receptor and high-efficacy partial agonist of the κ-opioid receptor. As per the developing company’s website [135], a phase II trial of this agent was expected to commence in the second half of 2019. No further updates are available.