Identifying clinical features associated with electroconvulsive therapy response in adolescents with major depressive disorder using machine learning
[Articles] Who receives psychiatry-focused pharmacogenomic testing, and is it associated with prescribing patterns and acute care utilisation in depression? Real-world evidence from a large health system
In routine clinical practice, PGx testing is preferentially used in youth and adults with clinically complex histories and is associated with shifts in antidepressant prescribing patterns. Exploratory findings suggest hypothesis-generating signals of reduced psychiatric ED utilisation among patients with higher psychiatric complexity, which requires further confirmation. Observed racial disparities highlight the need for earlier and more equitable implementation. Prospective studies incorporating symptom-level and safety outcomes are needed to determine whether PGx-guided prescribing translates into meaningful clinical benefit.
Comparing Usual Care With Coordinated Clinician and Patient Use of Mobile Technology in Primary Care for Patients With Major Depressive Disorder: Practice-Based Pilot Study
Ketamine With Dialectical Behavioural Therapy (DBT) for Suicidality in Individuals With Treatment-Resistant Depression and Borderline Personality Disorder (KET-DBT)
Interventions: Drug: Ketamine Hydrochloride; Drug: Midazolam Hydrochloride; Behavioral: Dialectical Behavioral Therapy (DBT)
Sponsors: Joshua Rosenblat
Not yet recruiting
Anxiety and Depression Associated With the Dependent Use of Generative AI in Medical Students: Cross-Sectional Study
Background: The growing integration of artificial intelligence (AI) in higher education has transformed learning processes but also raised concerns about potential mental health risks. Medical students represent a particularly vulnerable group due to high academic stress and increasing reliance on generative AI tools for study and decision-making tasks. Despite this, the relationship between AI dependence and psychological distress remains underexplored in Latin American contexts. Objective: This study aimed to evaluate the association between generative AI dependence and levels of stress, anxiety, and depression among medical students. Methods: A cross-sectional study was conducted with 187 human medicine students from a Peruvian university during the first academic semester of 2025. The Dependence on Artificial Intelligence Scale and the Depression, Anxiety, and Stress Scale–21 were applied. Negative binomial regression models, both crude and adjusted for sex, age, income, and year of study, were used to assess associations, reporting rate ratios (RRs) and 95% CIs. Results: Participants had a median age of 22 (IQR 19‐24) years, and 58.8% (110/187) were female. The median Dependence on Artificial Intelligence Scale score was 10 (IQR 7‐14). Generative AI dependence showed significant correlations with anxiety (ρ=0.336, 95% CI 0.22‐0.44) and depression (ρ=0.316, 95% CI 0.20‐0.43) and a smaller correlation with stress (ρ=0.277, 95% CI 0.16‐0.39). In the adjusted regression models, each 1-point increase in generative AI dependence was associated with a 5% higher expected anxiety score (RR 1.05, 95% CI 1.01‐1.09; =.01) and a 4% higher depression score (RR 1.04, 95% CI 1.01‐1.08; =.03), whereas the association with stress was positive but nonsignificant (RR 1.03, 95% CI 1.00‐1.07; =.08). Fifth-year students had significantly greater anxiety levels than their sixth-year peers (RR 1.82, 95% CI 1.09‐3.01; =.02). No significant effects were observed for sex, age, or income. Conclusions: This study empirically examined generative AI dependence as a distinct behavioral construct and its association with mental health symptoms in medical students. Unlike prior research, this study evaluated psychological dependence on generative AI and modeled its relationship with anxiety and depression using appropriate count-based regression techniques. By providing early evidence from a Latin American context, it contributes to the emerging field of digital mental health and medical education research. These findings underscore the need for universities to promote balanced and responsible AI use, integrate digital literacy with mental health support strategies, and develop preventive policies that mitigate potential maladaptive reliance on generative AI tools.
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Psilocybin-Induced Brain Changes May Explain Therapeutic Effects
Researchers at University of California, San Francisco and Imperial College London have shown that a single dose of psilocybin, the psychedelic compound found in magic mushrooms, causes likely anatomical brain changes that last for up to a month after the experience.
The study, involving healthy volunteers who had never taken a psychedelic, links temporary shifts in brain “entropy”—which is the diversity of neural activity occurring in the brain—to insight. This suggests the psychedelic trip itself is important to the drug’s longer term therapeutic effects.
The researchers found that a high dose of psilocybin led to increased entropy in the minutes and hours after taking the drug. The degree of entropy predicted how much insight, or emotional self-awareness, the participants felt the next day; and this, in turn, forecasted improvements in their sense of wellbeing a month later.
The findings may help to explain psilocybin’s therapeutic effects on conditions such as depression, anxiety, and addiction. “Psychedelic means ‘psyche-revealing,’ or making the psyche visible,” said senior author Robin Carhart-Harris, PhD, the Ralph Metzner distinguished professor of neurology at UCSF. “Our data shows that such experiences of psychological insight relate to an entropic quality of brain activity and how both are involved in causing subsequent improvements in mental health. It suggests that the trip—and its correlates in the brain—is a key component of how psychedelic therapy works.” Carhart-Harris is senior and corresponding author of the team’s published paper in Nature Communications, titled “Human brain changes after first psilocybin use.”
“Psychedelics have robust effects on acute brain function and long-term behavior but whether they also cause enduring functional and anatomical brain changes is largely unknown,” the authors wrote. Psilocybin is the precursor of the compound psilocin, a serotonin receptor agonist. “Converging evidence supports a role for serotonin 2A receptor (5-HT2AR) agonism in eliciting the characteristic brain and subjective effects of this and related psychedelics in humans,” the team continued.
For their newly reported study, Carhart-Harris and colleagues carried out an exploratory, placebo-controlled, within-patient study in 28 psychedelic-naïve participants who each received a single, high-dose (25 mg) of psilocybin. The researchers used an assortment of brain imaging and brain measurement techniques, some of which were carried out during the peak of the psychedelic experience, as well as before and one-month after drug administration. “This was an exploratory, hypothesis-generating mechanistic study in healthy volunteers,” the authors noted. None of the 28 people in the study had a diagnosed mental health condition, which gave the scientists greater freedom to do more testing.
In the first part of the experiment the subjects were given a 1 mg dose of psilocybin, which the researchers regarded as a placebo, and were then monitored with EEG, which records brain activity from electrodes on the scalp. Over the next few weeks, the researchers measured their subjects’ psychological insight, wellbeing, and cognitive ability. They examined brain activity with functional MRI (fMRI) and brain connectivity with diffusion tensor imaging (DTI).
One month after the placebo, the subjects were given 25 mg of psilocybin, a dose capable of eliciting a strong psychedelic trip. During the experience, researchers again measured the subjects’ brain activity with EEG, and in the following weeks they repeated the same tests they had given after the 1 mg dose.
This enabled the scientists to compare the effects of the psychedelic trip on the brain and mind to the effects of the placebo. “The multimodal neuroimaging design allowed us to observe changes in brain function and (potential) anatomy from 1-h (EEG) to 1-month (DTI) after high-dose psilocybin,” they explained.
The investigators found that within 60 minutes of taking the 25 mg dose of psilocybin, EEG revealed higher entropy, suggesting that the brain was processing a richer body of information under the psychedelic. A month later, the researchers looked at their subjects’ brains using DTI, which measures the diffusion of water along neural tracts in the brain, and found that they were denser and had more integrity. This is the opposite of what happens in aging, which makes these tracts more diffuse.
The researchers cautioned that more work needs to be done to better understand the meaning of this finding, but the result is a never-before-seen sign of how psychedelics can change the brain. ”The inclusion of DTI enabled us to test for long-term changes in the integrity of white matter tracts post psilocybin,” the authors stated. “Results revealed decreased axial diffusivity in prefrontal-subcortical tracts 1-month post 25mg psilocybin.”
The day after the 25 mg dose, all but one of the 28 subjects rated the trip as the “single most” unusual state of consciousness they had ever experienced. The remaining person rated it as among their top five. The study participants said they had experienced more psychological insight after taking the 25 mg of psilocybin than they had after the 1 mg placebo. The subjects also reported increased wellbeing two and four weeks after the study. This was measured from responses to statements such as, “I’ve been feeling optimistic about the future,” and “I’ve been dealing with problems well.”
As the scientists noted in their paper, “A predictive relationship was also found between brain entropy and longer-term mental-health changes—namely, improved wellbeing. Improved wellbeing could be predicted directly from acute increases in brain entropy as early as 1-h post dosing.”
A month after the study the study individuals also scored better on a test of cognitive flexibility. “Psilocybin seems to loosen up stereotyped patterns of brain activity and give people the ability to revise entrenched patterns of thought,” said first author Taylor Lyons, PhD, a research associate at Imperial College London. “The fact that these changes track with insight and improved well‑being is especially exciting.”
The scientists found that the subjects who had experienced the largest increases in brain entropy in the minutes to hours after taking psilocybin were the most likely to have increased insight the next day and increased wellbeing a month later. The researchers concluded that improved wellbeing was driven by the experience of insight.
The authors suggest that the study findings could improve treatment for people with mental illness using psilocybin, for example, by ensuring that the right dosage is used to produce the right amount of brain entropy to promote insight. “We already knew psilocybin could be helpful for treating mental illness,” Carhart-Harris said. “But now we have a much better understanding of how.”
In their paper the team concluded, “The present multi-modal neuroimaging study in healthy participants sheds light on the brain effects of first-time high-dose psychedelic use and the therapeutic action of psilocybin-therapy, suggesting that therapeutically relevant changes—i.e., improved wellbeing—can be forecast via an acute human brain action, i.e., an entropic brain effect, that is well-known to relate to the psychedelic experience … Results support a role for psychological insight in mediating the causal association between the entropic brain effect and potentially enduring improvements in wellbeing.”
The post Psilocybin-Induced Brain Changes May Explain Therapeutic Effects appeared first on GEN – Genetic Engineering and Biotechnology News.
Genotype-Guided Antidepressants Could Have Long-Term Benefits
Prescribing antidepressants according to a patient’s genetic makeup could help manage depressive symptoms in the long-term, a clinical trial suggests.
The findings, in JAMA Network Open, suggest pharmacogenetic guidance could have extended benefits, which may not be apparent early on.
Primary results did not indicate that genotype-guided SSRI treatment was better than usual care at three months in A Depression and Opioid Pragmatic Trial in Pharmacogenetics (ADOPT PGx).
However, significantly more patients receiving genotype-guided therapy achieved the secondary endpoint of depression remission at six months.
“Although outcomes were similar early in treatment, differences emerged over time,” noted Kathryn Blake, PharmD, from Nemours Center for Pharmacogenomics and Translational Research in Jacksonville, Florida, and colleagues.
“These findings suggest a possible longer-term clinical benefit and indicate that future studies should focus on evaluating the durability and long-term impact of genotype-guided prescribing in the management of depressive symptoms.”
SSRIs are the most common pharmacotherapy for depression and variants in cytochrome P450 enzymes CYP2D6 and CYP2C19 can affect their metabolism, influencing exposure to this medication.
Indeed, guidelines from the Clinical Pharmacogenetics Implementation Consortium (CPIC) provide recommendations for SSRI prescribing when genotype information is available.
However, most psychiatry experts and practice guidelines for treating depression have not yet endorsed pharmacogenetic-informed therapy, citing insufficient evidence.
ADOPT PGx was a set of three randomized clinical trials, designed to test whether routine use of pharmacogenetic testing improves medication response among patients with depression, acute pain, or chronic pain.
The ADOPT PGx Depression trial included 221 children and 1239 adults, aged eight years or older who had experienced depression for three months or longer.
A total of 692 patients (47.4%) had an actionable phenotype, of whom 351 (50.7%) were assigned to the intervention, and 341 (49.3%) to usual care.
Among this group, two-thirds reported having depressive symptoms for more than two years, and three quarters were female. The vast majority were on pharmacologic treatment, at 87.1%, with just over half receiving nonpharmacologic treatment.
Participants were randomly assigned to genotype-guided SSRI prescribing or usual care to examine whether pharmacogenetic guidance improves depression over six months.
At three months, there were no significant differences between the intervention and usual care groups in the primary endpoint of change in Patient-Reported Outcomes Measurement Information System (PROMIS) depression T scores among patients with an actionable phenotype.
At this timepoint, there were also no differences in the secondary outcome of adverse effect severity.
However, another secondary endpoint of depression remission according to a PROMIS depression T-score of 16 or less was more likely with the intervention than usual care, at 48.3% (153 of 317 patients) versus 39.4%. (122 of 310 patients).
Based on this, the authors proposed: “These findings suggest that pharmacogenetic testing, including evaluation for CYP2D6 enzyme inhibition (phenoconversion), may offer meaningful benefit with longer follow-up.”
The post Genotype-Guided Antidepressants Could Have Long-Term Benefits appeared first on Inside Precision Medicine.
STAT+: Pharmalittle: We’re reading about RFK Jr. targeting antidepressants, J&J pushing an IBD drug, and more
Rise and shine, another busy day is on the way. However, this is also shaping up as a beautiful day as well, given the clear and sunny skies — and delicious breezes — enveloping the Pharmalot campus this morning. This calls for celebration with a cup of stimulation, and we are opening a new package of cinnamon buns for the occasion. Spring has sprung, after all. What is upon us right now, however, is our ever-growing to-do list. Sound familiar? So here are some items of interest. Have a great day, everyone. …
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced several initiatives intended to rein in the prescription of selective serotonin reuptake inhibitors, the most widely prescribed class of antidepressants, which he has described as exceptionally difficult to quit, The New York Times writes. The initiative focuses on the most widely prescribed class of psychiatric medications, first-line treatments for depression and anxiety that include Zoloft, Lexapro, Paxil, and Prozac. In 2026. 16.7% of U.S. adults, or roughly one in six, reported currently taking one of these pills. The changes — new trainings, reimbursement mechanisms, and clinical guidelines — nudge clinicians to help patients get off medications, and to consider non-pharmaceutical interventions, like therapy, nutrition, and exercise.
A closely watched therapy developed by Johnson & Johnson failed to show a statistically meaningful improvement for patients with inflammatory bowel disease. But the company plans to advance the drug into late-stage testing, focusing on a growing subgroup of patients, STAT tells us. On Tuesday, trial investigators presented the results of a study that tested how well combining the drugs Tremfya and Simponi would stop the immune system from mistakenly attacking healthy tissues in the digestive tract. J&J tested the combined therapy in two Phase 2b clinical trials hitting both major forms of inflammatory bowel disease — ulcerative colitis and Crohn’s disease. In each trial, the combination performed better than the individual drugs, but did not meet the primary endpoint of clinical remission.

