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Current therapies for depression are moderately effective, as response and remission rates were reported at 50% and 15-40%, following the first trial with current medications, respectively, and electroconvulsive therapy is not beneficial for more than half of the resistant patients. Recent research suggests that medication with glutamatergic modulatory properties may have antidepressant effects and would be of benefit to refractory patients. This study aims to review the efficacy of these medications in the treatment of unipolar depression. Ketamine, as the leading drug acting through the glutamatergic system, appears to be effective in treating depression IV and orally and in combination with electroconvulsive therapy. There is also clinical evidence of the promising effects of amantadine and lanicemine. Supplements and herbs such as L-carnosine, Crocus sativus (saffron), and Cinnamomum tamala, which were reported to be effective in randomized controlled trials on patients with depression, may act through this system as an antidepressant. Taken together, glutamate receptor modulators are alternative drugs for patients with resistant depression. Further high-quality clinical studies are recommended. [ABSTRACT FROM AUTHOR]

About one-fifth of cannabis users, the most commonly used illicit substance, have cannabis use disorder (CUD). Psychiatric disorders and suicide are more common in these patients, and the disability-adjusted life years were reported to be 0.69 million. Pharmacotherapy for CUD is an unmet public health need, as current evidence-based therapies have limited efficacy. After explaining the pathophysiology of CUD, the effects of emerging pharmacological interventions in its treatment obtained from randomized controlled trials were reviewed in light of mechanisms of action. Superiority over control of cannabidiol, gabapentin, galantamine, nabilone plus zolpidem, nabiximols, naltrexone, PF-04457845, quetiapine, varenicline, and topiramate were observed through the cannabinoid, glutamatergic, γ-aminobutyric acidergic, serotonergic, noradrenergic, dopaminergic, opioidergic, and cholinergic systems. All medications were reported to be safe and tolerable. Adding pharmacotherapy to psychotherapy is the optimal treatment for CUD on a case-by-case basis. Drug development to add to psychotherapy is the main path, but time and cost suggest repurposing and repositioning existing drugs. Considering sample size, follow-up, and effect size, further studies using objective tools are necessary. The future of CUD treatment is promising. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder, of unknown etiology, that affects 2.5% of the population. An appropriate therapeutic response to conventional treatment is seen. Some studies use augmentative treatment by antipsychotics, glutamatergic, lithium, buspirone, and others agents to improve the therapeutic response. In this study, we aimed to evaluate the efficacy and tolerability of aripiprazole and quetiapine as augmentative treatments in patients with selective serotonin reuptake inhibitor (SSRI) refractory OCD. The OCD patients were initially treated for 12 weeks with a SSRI. If after 12 weeks their Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score was more than 16, they were randomly assigned to either the aripiprazole or the quetiapine augmentation group for an additional 12 weeks. There were no significant differences in age, sex, education, marital status, or score of Y-BOCS and Clinical Global Impression-Severity Scale (CGI-S) between groups (p > 0.05) at the outset of the study. Significant differences were noted after 1 month when compared with results at 2, 3, and 4 months in both groups (p < 0.001). Both quetiapine and aripiprazole may be effective and well-tolerated augmentative agents in the treatment of SSRI-refractory OCD. Because of positive results, aripiprazole may be considered more effective and may have a more rapid onset in terms of therapeutic response. Key words: treatment-resistant, obsessive-compulsive disorder, quetiapine, aripiprazole. Le trouble obsessif compulsif (TOC) est un trouble psychiatrique chronique dont l'etiologie est inconnue et qui touche 2,5 % de la population. On observe une reponse therapeutique appropriee avec le traitement classique. Certaines etudes mettent a profit un traitement augmentatif par des agents antipsychotiques, glutamatergiques, le lithium, la buspirone, entre autres, en vue d'ameliorer la reponse therapeutique. Dans cette etude, nous visions a evaluer l'efficacite et la tolerabilite de l'aripiprazole et de la quetiapine en tant que traitements augmentatifs chez des patients atteints d'un TOC refractaire aux inhibiteurs selectifs de la recapture de la serotonine (ISRS). Nous avons tout d'abord traite les patients atteints de TOC pendant 12 semaines par un ISRS. Si les patients presentaient un score superieur a 16 a l'echelle obsessive compulsive de Yale-Brown (Y-BOCS) apres 12 semaines, nous les repartissions aleatoirement dans le groupe augmentatif aripiprazole ou quetiapine pour 12 semaines supplementaires. A la conclusion de l'etude, nous n'avons observe aucune difference marquee selon l'age, le sexe, l'instruction, l'etat civil ou les scores de Y-BOCS et echelle clinique global d'mpression-gravite (CGI-S) entre les groupes (p > 0,05). Apres 1 mois, nous avons observe des differences notables par rapport aux resultats apres 2, 3 et 4 mois dans les deux groupes (p < 0,001). La quetiapine comme l'aripiprazole pourraient etre des agents augmentatifs efficaces et bien toleres dans le traitement du TOC refractaire aux ISRS. Etant donne des resultats positifs, l'aripiprazole pourrait etre consideree comme etant plus efficace et pourrait etre associee a une reponse therapeutique se manifestant plus precocement. [Traduit par la Redaction] Mots-cles : resistance au traitement, trouble obsessif compulsif, quetiapine, aripiprazole., Introduction Psychiatric disorders cover a wide range of problems such as social anxiety, panic, depression, attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD) (Etchepare et al. 2016; Harika-Germaneau et al. 2014; [...]

Background and Aim: Crocus sativus also known as saffron, is one of the most popular traditional plants. This study aims to evaluate the efficacy and safety of saffron extracts in ADHD. Method: This study includes clinical trial studies that assessed the efficacy and/or safety of saffron in ADHD patients. Non-English papers, review articles, commentaries, letters, observational studies, thesis, animal studies, in-vitro studies, and conference abstracts were not included. The risk of bias in randomized studies was evaluated based on the Cochrane RoB.2, and risk of bias in pre-post intervention studies was assessed using the ROBINS-I tool. Results: Four studies met our inclusion criteria with a total of 118 patients. The results manifested an efficient role of saffron as either an adjuvant therapy to MPH or a single therapy against ADHD, without significant safety issues. Discussion: Saffron demonstrates promise in improving ADHD symptoms, with an acceptable safety profile. Future well-designed multicentral studies are suggested. [ABSTRACT FROM AUTHOR]