Fifteen Eighty Four

Academic perspectives from Cambridge University Press


CNS Spectrums supports Mental Health Awareness Month

Stephen M. Stahl

I have the privilege of editing the journal known as CNS Spectrums, which gives me a great vantage point to view the progress and developments in the field of mental health, especially in areas where we focus, such as the neurobiological basis of the more serious mental illnesses and their treatments, for example of schizophrenia, mania, depression, obsessive compulsive disorder, and others. There have been some startling advances and some disappointments in the past year.  The good news is the FDA approval of an inhaled form of an antidepressant, esketamine, Spravato, for patients who do not respond to other antidepressants. Spravato has a rapid onset, and has to be given in the doctor’s office.  It may also help rapidly relieve suicidal thoughts in patients with serious depression. Another FDA approval is for the treatment of postpartum depression, in women who have just delivered a baby. The drug is brexanolone, Zulresson, which is given as an intravenous infusion for 60 hours, with rapid and sustained benefit, faster and more effective than other treatments.  Postpartum depression can be associated with serious disability, even suicide, and difficulty bonding with the newborn baby.   Other advances include new treatments for a complication of antipsychotic use, namely a movement disorder called tardive dyskinesia (Ingressa and Austedo).

On another note, there is increasing appreciation that opioid addiction should be treated with medications, not just rehab and cold turkey, for best results (medication assisted treatment with buprenorphine or a long acting injection of naltrexone). A big disappointment seems to be the failure of the amyloid theory of Alzheimer’s Disease and of every treatment that targets amyloid, taking us back to the drawing board to try to find what is wrong with this dementia that we can target to stop or prevent it.

In the meantime, the good news is that new treatments are on the horizon for some of the behavioral symptoms of dementia such as agitation and psychosis. Finally, we have learned more about the neurotransmitter dopamine and its newly targeted receptor, the D3 receptor. New guidelines for how to assess cognition are also in hand for various psychiatric disorders, published this year. Finally, we even published a special issue on evil, psychiatry, and terrorism, asking whether terrorism is a psychiatric disorder and proposing that it is not, but is instead a form of evil.  Many of these topics are covered in a recurring feature in our journal called Brainstorms, and we look forward to another exciting year of advances in the understanding and treatment of mental illnesses.

CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator.

You can read the latest articles on mental health from CNS Spectrums as well as book chapters and journal articles in this subject area here. Free access to all content is available for the entire month of May 2019.

Cambridge University Press have curated a collection of free work across a variety of related topics – view the full collection at www.cambridge.org/MHAM19

About The Author

Stephen M. Stahl

Dr. Stephen M. Stahl received his undergraduate and medical degrees from Northwestern University in Chicago, as a member of the honors program in Medical Education and his Ph.D. de...

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