The edition · Psychiatry
Theta-burst stimulation helped older adults with depression, but only by week 12
A sham-controlled trial in late-life depression, a pilot comparing magnetic seizure therapy with ECT in bipolar depression, an injectable buprenorphine recall, and why a suicide risk model still misses most cases.
The edition in brief
In a triple-blind trial of 108 adults aged 60 and over with moderate to severe depression, bilateral theta-burst stimulation did not beat sham at week 6 (HAM-D difference -1.65, 95% CI -3.38 to 0.08) but did at week 12 (-1.89, -3.75 to -0.03), with response in 52% against 33%. A 55-patient pilot found similar remission after magnetic seizure therapy and right unilateral ultrabrief ECT in bipolar depression (20% vs 30%), with a clinically important autobiographical memory decline in 7.1% vs 22.2%; the authors call it preliminary. The FDA classified a recall of buprenorphine hydrochloride injection 0.3 mg/mL (Class II, ongoing) because of crystallisation. A US Army machine-learning study of 1.9 million health assessments produced a suicide model with AUROC 0.72 that flagged only 18.6% of suicides within its top 5% risk band.
Bilateral theta-burst stimulation in late-life depression: no benefit at 6 weeks, a modest one at 12
Consider theta-burst stimulation as a later-response option in late-life depression, and tell patients not to expect a clear gain by week 6.
Magnetic seizure therapy against ECT in bipolar depression: a small pilot
Magnetic seizure therapy looks like a possible lower-memory-burden alternative to ECT, but the evidence is a small pilot and preliminary.
FDA Class II recall of buprenorphine hydrochloride injection 0.3 mg/mL
If you hold the recalled US vials, check the lot against the FDA notice and quarantine matching stock.
Ask about suicidal thoughts directly, and ask again
Ask directly about suicide at each contact; do not depend on a tool or score to do the asking for you.
A suicide prediction model built on 1.9 million assessments still misses most cases
Consider risk tools as a way to prioritise resources, not to rule anyone out; keep asking and planning for everyone.
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