“In addition to a more granular conceptualization of anhedonia, future studies would greatly benefit from assessment of anhedonic behavior in daily life,” writes Dr. Randy P. Auerbach and colleagues.
"As far as prevention goes, the beneficial effect of ramelteon looks pretty strong, but the amount of evidence for its efficacy is actually pretty low," Dr. Peter Shapiro said.
Dr. Paul S. Appelbaum and colleague examine the multiple changes looming in both the doctor’s and the patient’s roles in the move toward precision medicine.
“Going from not knowing each other to identifying shared interests is one of the first steps in making new friends and apps, online communities, the internet can fast track that,” Dr. Ali Mattu said.
“Approval of esketamine is important for patients because other options like transcranial magnetic stimulation work more poorly in medication-resistant depression,” writes Dr. J. John Mann.
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Dr. Alan S. Brown, said that "overall, the investigators have done a commendable job." However, he also noted that the "findings could also be influenced by treatment-seeking behaviors."
When the drug works, its effect is almost immediate. That speed “is a huge thing because depressed patients are very disabled and suffer enormously,” said Dr. John Mann.
“This is undeniably a major advance,” said Dr. Jeffrey Lieberman. But he cautioned much is still unknown about the drug, particularly regarding its long-term use.
