Advances in the Management of Major Depressive Disorder - Episode 9
Dr Andrew Cutler and Dr Greg Mattingly comment about emerging treatments to treat anhedonia and highlight lifestyle modifications that support the wellbeing of patients with Major Depressive Disorder.
In addition to the dextromethorphan-bupropion combination, the clinicians review other evidence-based treatments for anhedonia. These include medications modulating dopamine, glutamate, kappa opioid receptors, and psychedelics. Lifestyle approaches like exercise, diet, sleep, social connection, and purpose are also critical, improving motivation and pleasure by enhancing BDNF, endorphins, and dopamine while decreasing inflammation.
They emphasize assessing and tracking residual symptoms like anhedonia even in patients considered asymptomatic or “in remission” on rating scales, as lingering lack of enjoyment, drive, or interest predicts later recurrence and dysfunction. Using practical measures of life engagement and specific hobbies, relationships, or tasks is recommended over formal rating scales to identify ongoing areas of impairment.
In closing, the clinicians express excitement about the expanding treatment options to address unmet needs like motivation and pleasure that have been resistant to standard interventions. They urge clinicians to utilize both new tools emerging from ongoing research as well as digital measures and benchmarking to ensure treatment gets patients to optimal functioning, not just minimal symptom reduction. Keeping skills updated and identifying patients struggling with residual symptoms is key to enabling fuller recovery.
This summary was AI-generated and edited for clarity.