They suggest that future research should directly compare oral and depot naltrexone, systematically assess blinding, and account for comorbidities and sex differences to clarify ketamine’s mechanisms of action and guide clinical practice

Check the paper for + info: doi.org/10.1093/ijnp...

A recent commentary by @igorbandeira.bsky.social et al. highlights the steps in clinical trial design that combine ketamine and naltrexone for major depression, allowing for a mechanistic approach.

@stanfordpsy.bsky.social
#depression #opiod #ketamine #resistantdepression #clinicaltrials

💊 Distinct D₂R binding poses may produce clinically meaningful differences in efficacy, onset, and tolerability

📄 Read the full study here: doi.org/10.1093/ijnp...

⚙️ Mechanistic insight:
Aripiprazole / brexpiprazole → SBP-dependent binding
→ May help stabilize dopaminergic tone and reduce extrapyramidal side effects.

Cariprazine / lumateperone → canonical D₂R binding, faster dynamics
→ Could underlie different temporal or regional dopamine modulation.

🧩 In this study, 4 clinically approved D₂R partial agonists (DPAs) were tested for how they interact w/ a secondary binding pocket (SBP) in the receptor

🔬 Key finding:
Mutating a residue in the SBP(L94A) accelerated dissociation of aripiprazole and brexpiprazole, but not cariprazine or lumateperone

Given prolactin’s roles in mood, stress, sexual health, and bone metabolism, early endocrine assessment could inform sex-specific care in schizophrenia.

🔗 Read +: doi.org/10.1093/ijnp...
#Schizophrenia #Endocrinology #Psychiatry #FirstEpisodePsychosis #Neuroendocrinology

📊 Abnormal PRL levels were nearly 4× more frequent in males than in females.
📊 HyperPRL patients also showed higher testosterone and FSH

These findings suggest that PRL–gonadal hormone dysregulation may be intrinsic to psychosis onset, not only drug-induced.

🧩 Read more: doi.org/10.1093/ijnp...

#Neuroscience #Microbiome #BrainHealth #Surgery #Aging #Nutraceutical

🔥In aged mice, gut dysbiosis worsened POCD by increasing brain inflammation.

💊Treatment with the probiotic VSL#3 restored healthy gut bacteria, reduced neuroinflammation, and improved memory via the AMPK/SIRT1 pathway, a key regulator of energy balance and inflammation ⚡

Discover more: doi.org/10.1093/ijnp...
#Antidepressant #Duloxetine #MDD #Pharmacology #MedEd

🧠 Confirmed NET Occupancy:~30-40% at therapeutic doses with no differences in avaiability pre and post treatment
📈 Clinical Correlation: NET availability associated with clinical improvement
⚖️ Synergy: NET + SERT occupancy (~80%) reinforce efficacy in MDD

By integrating personality dimensions into diagnostic evaluation, the study opens new perspectives for refining classification and advancing personalized treatment strategies in psychiatry.

Check the paper to find more: doi.org/10.1093/ijnp...

This reinforces that lithium modulates unique metabolic mechanisms. However, predicting who will respond remains a complex challenge that has not yet been solved by blood metabolomics.

Read more here: doi.org/10.1093/ijnp...

#BipolarDisorder #Psychiatry #Lithium #MoodStabilizers

A new study investigated this by analyzing the blood metabolome of BD patients
✅ Lithium & other MS have different metabolic signatures in pathways involving glucose, pyruvate and glutamate metabolism
❌ The study found no significant differences between responders and non-responders
#Metabolomics

These findings argue for the assessment of anhedonia in clinical practice to better guide treatment management

Read+: doi.org/10.1093/ijnp...

💊Findings reveal a treatment-resistance profile for the anhedonic #MDD. Data suggests #SSRIs may be less effective to non-anhedonic MDD, supporting the need for targeted, non-5HT therapeutic strategies

🦋 The MDD profile was related to specific somatic comorbidities, notably thyroid dysfunction and Type 2 Diabetes Mellitus #T2DM. The link highlights the possible role of disruption in reward circuitry and endocrine function.