Enhancing Depression Treatment: Rapid-Acting Antidepressants Accelerate Onset of Relief

"Our understanding about the pathophysiology of major depressive disorder has changed tremendously over the past few years," says  Ahmed Baig, MD, chief medical officer at Midwest Research Group, St. Louis, Missouri.

Dr Baig chatted with Psych Congress Network about his Psych Congress 2023 session "Expert Panel: Real-World Impact of Rapid-Acting Antidepressants," which he co-presented with Greg Mattingly, MD; Rachel Dalthorp, MD, MHSA; and Patient Advocate Cheryl Meier.

In this video, Dr Baig examines the mechanisms of action in these new therapies, how the medical world's understanding of the pathophysiology of major depressive disorder has changed, and how clinicians can help to "win the battle against depression."

Catch up on other Psych Congress 2023 coverage in our Psych Congress Newsroom.

Read the Transcript:

Meagan Thistle, Psych Congress Network: What are the key differences in the mechanisms of action between traditional antidepressants and rapid-acting antidepressants? How do these differences contribute to faster treatment onset? 

Dr Ahmed Baig: Our understanding about the pathophysiology of major depressive disorder has changed tremendously over the past few years. What we now understand is it's a lot less to do with the traditional chemical imbalance or monoamine hypothesis, and it's much more to do with disruption in the glutamatergic system in the brain, GABA, and glutamate.

The easiest best way to think about that is GABA is usually the brake pedal of the brain. It's the major inhibitory transmitter, and glutamate is like the gas pedal, and it's not necessarily disruption in levels of one or either. It's the levels, the overall homeostasis is off. And because those two chemicals in the brain are so much more abundant, significantly more so than serotonin, norepinephrine, that contributes to the ability of rapid-acting antidepressants to have extremely quick onset. So a matter of hours or days versus months and weeks. Also, a big component of it is given that they're much more abundant and they're involved in significantly more processes in the brain that are affected by depression, we see much more complete symptomatic resolution than we have traditionally with antidepressants.

This is all important because we're losing the battle against depression. Suicide rates over the past 14 years have almost doubled. Depression continues to be the leading cause of disability worldwide, and by every measurable metric, it's one of the leading causes of death in the United States. So we're failing our patients. We need to do better, and these new rapid-acting antidepressants give us the ability to finally restore quality of life and function in patients who need it so desperately.

Ahmed Baig, MD, is chief medical officer at Midwest Research Group and trained at Saint Louis University School of Medicine. He has been involved in clinical research trials for the past 10 years and over 40 clinical studies. Currently, under the direction of primary investigator Dr Greg Mattingly, Dr Baig and Midwest Research Group are conducting several clinical trials for novel therapeutics in the treatment of MDD and TRD, bipolar disorder, ADHD, and schizophrenia.