Today, we count down the top 10 research updates of the past year.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chrisaken, the editor-in-chief of the Carlyte Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Every September, I present the top 10 research findings of the past year at the North Carolina Psychiatric Association's annual meeting.

This September, the talk was canceled by Hurricane Helene.

But I'm going to count them down here, from 10 to 1.

The trials are really in no particular order.

And I'm going to start with two that have changed how I think for treatment-resistant depression, transcranial magnetic stimulation TMS, switching antidepressants to an SNRI or a tricyclic, or augmenting the antidepressant with

aeropipypersol. In each study, TMS won the day, but there are subtleties here that will

turn down that enthusiasm a few notches. Both of these trials enrolled patients with true treatment resistance,

that's a rare thing, those who failed at least two antidepressants. Both lasted eight weeks,

and both were funded by non-profits. Both were randomized controlled trials, but neither

of them involved a placebo arm, and neither were double-blinded.

That means that patients and their doctors were aware of which treatments were being used.

It is, after all, difficult to blind people to the use of TMS, but if they had more funding, they could have arranged a sham TMS arm.

The Raiders, at least, were blind to the treatments.

So let's look at these two trials in more detail.

The largest of them is the ascertained TRD trial, a multi-site study involving 278 patients with TRD who were randomized to

TMS, which was added to their current antidepressant, augmentation with Arapersol, the mean

dose was 9 milligrams a day, or switching to an SNRI, either Venlifaxine at a mean of 191 milligrams a day,

or duloxatine at a slightly higher mean of 98 milligrams a day.

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