Abstract

Ankita Verma, Tirthankar Choudhury

ABSTRACT

Even though conventional treatments based on monoamines do not always produce complete remission, major depressive disorder (MDD) is still one of the top causes of disability worldwide. An important step forward is the increased utilization of glutamatergic modulators such esketamine (Spravato). For patients with treatment-resistant depression (TRD), Spravato was the first monotherapy to receive FDA approval in January 2025. Novel oral medicines that target mood without common side effects including sexual dysfunction include 5-HT1A receptor agonists like gepirone (Exxua). Zuranolone and other GABA-ergic modulators have also made strides in the treatment of postpartum depression, while psychedelic-assisted therapies like psilocybin and MDMA have shown promising results in clinical trials, providing significant alleviation through neuroplasticity. With the introduction of streamlined 3-minute procedures, transcranial magnetic stimulation (TMS) has became more accessible. One highly accurate method for severe TRD is deep brain stimulation (DBS). Information Technology for Medical Treatment: Recently, the FDA approved digital treatments for prescription use, such as Rejoyn, which provides cognitive behavioral therapy (CBT) by smartphone. Immersive VR-based cognitive behavioral therapy (CBT) is becoming more popular as a means to alleviate symptoms through the provision of secure settings for emotional processing. In order to control neuroinflammation, the latest fads center on the gut-brain axis and anti-inflammatory diets that include probiotics. Another emerging field, precision psychiatry, is utilizing genetic testing and AI algorithms to personalize therapies based on an individual's biological profile. This approach greatly enhances the success rates of those who had previously struggled with standard care. Novel biomarkers can be used to get insight into the underlying faulty circuits. Finally, it also discusses the role of metabolites in anxiety, as it is more focused that the therapies for anxiety disorders may be made possible by the incorporation of biomarkers that may aid in better diagnosis and the development of a classification system for psychiatric diseases that may be linked to the faulty circuits underlying them.