Psychiatry

Maintenance antidepressants did not preserve positive facial emotion recognition biases

In adults with recurrent depression well on maintenance antidepressants, discontinuation did not change happy face classifications at 12 or 52 weeks versus continuation. Adjusted mean differences were near zero at 12 weeks (0.23; 95% CI -0.5 to 1.0) and 52 weeks (0.29; -0.5 to 1.2). Depressive symptom severity correlated with fewer happy classifications, while anxiety correlated with more happy classifications. The trial challenges extrapolating short-term laboratory emotional-bias effects to long-term maintenance treatment and calls for mechanistic research. 1

Methylphenidate use in adults with MDD linked to fewer hospital/ER events and no increased psychiatric harms

In a propensity-matched cohort of 3,211 pairs with MDD, methylphenidate initiation was associated with lower composite hospital/ER events over one year (HR 0.85; 95% CI 0.76–0.95). No significant differences were found for hospitalization, emergency visits, suicidal behavior, manic episodes, or MDD recurrence. Findings were consistent across sex, age, and antidepressant-class subgroups. Results support psychiatric safety of adjunctive methylphenidate in selected, stabilized adults with MDD, pending longer follow-up. 2

Genotype-guided SSRI prescribing improved 6-month remission but not 3-month symptoms

In the ADOPT PGx randomized trial (N = 1,460), genotype-guided SSRI choice did not change 3-month PROMIS depression T-score improvements versus usual care. At 3 months there were no differences in adverse effect burden or PHQ-8 change. By 6 months, remission rates favored genotype-guided prescribing (reported improvement in remission). This pragmatic result suggests possible delayed benefit from genotype-guided SSRI selection, requiring replication and assessment of cost-effectiveness. 3