Experts discuss top past, future breakthroughs in psychiatry

Rakesh Jain

NEW ORLEANS — In accordance with the 30th anniversary of Psych Congress, Rakesh Jain, MD, MPH, of Texas Tech Health Sciences Center, Midland, Texas, and Charles L. Raison, MD, of the University of Wisconsin-Madison, reflected on past monumental breakthroughs in psychiatry as well as up-and-coming advances in the field.

One of the first major breakthroughs in psychiatry within the last 30 years was selective serotonin reuptake inhibitors, the presenters asserted.

“It seemed like all of a sudden, we had a freebie, an amazing agent that had minimal side effects and took people in these chronic struggles with their personality and their mood and transformed them into these energetic, smiling, positive people,” Raison said. “I think we had a sense of empowerment at that time that is really hard for us to wrap our minds around now.”

Other past breakthroughs in psychiatry highlighted include:

Atypical antipsychotics;
The STAR*D study, which taught the real-life effects of SSRIs;
Third-generation psychotherapies, including functional analytic psychotherapy, the cognitive behavioral analysis system of psychotherapy, compassionate mind training, dialectical behavioral therapy, metacognitive therapy, and more;
Ketamine and psychedelics; and
Brain imaging.

Regarding the future, Raison expressed excitement about the potential of human microbial interactions.

“What is very clear now is that across an astounding array of disease states, the relationship between the microbiota — a massive ecosystem of living organisms — and ... our bodies is instrumental to health in ways we never would have imagined a decade ago,” he said.

Other future breakthroughs in psychiatry addressed were:

Parenterally administered antidepressants, including IV ketamine, esketamine and rapastinel;
Virtual reality therapy; and
Mental wellness.

There has been a rise in global focus on wellness, according to Jain. However, “Here in the United States, we are slowly taking note,” he said.

Many medical, nursing and physician assistant schools are establishing wellness programs for students, which is a step in the right direction, but more work needs to be done.

To support wellness, Jain encouraged clinicians to proactively measure illness and wellness in patients and focus on preventive psychiatry and wellness.

He predicted that eventually, “Mental wellness will be seen as a basic human right.” – by Amanda Oldt

Reference:

Jain R, et al. Relishing the past and welcoming the future: Examining psychiatry’s recent and future breakthroughs. Presented at: U.S. Psychiatric and Mental Health Congress; Sept. 16-19, 2017; New Orleans.

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