Education
The research behind our care
Answers to the questions we hear most, grounded in published clinical research on the treatments we offer.
These summaries are for education only and are not medical advice. Some uses described here are off-label. Talk with your clinician about whether a treatment is right for you.
Spravato (Esketamine)
Major depressive disorder
American Journal of Psychiatry · 2019
Flexibly dosed esketamine nasal spray plus a new oral antidepressant in treatment-resistant depression (TRANSFORM-2)
Adding esketamine to a new antidepressant reduced depression scores more than the antidepressant alone over four weeks.
Read on PubMed →JAMA Psychiatry · 2019
Esketamine nasal spray plus oral antidepressant for relapse prevention in treatment-resistant depression (SUSTAIN-1)
Patients who stayed on esketamine after improving were significantly less likely to relapse than those switched to placebo.
Read on PubMed →New England Journal of Medicine · 2023
Esketamine nasal spray versus quetiapine for treatment-resistant depression (ESCAPE-TRD)
In a head-to-head trial, more patients reached remission with esketamine than with extended-release quetiapine.
Read on PubMed →Journal of Clinical Psychiatry · 2020
Esketamine for rapid reduction of depressive symptoms in patients with active suicidal ideation (ASPIRE I)
Esketamine added to standard care reduced depressive symptoms within 24 hours in patients with major depression and suicidal thoughts.
Read on PubMed →TMS (Transcranial Magnetic Stimulation)
Depression
Biological Psychiatry · 2007
Efficacy and safety of TMS in the acute treatment of major depression: a multisite randomized controlled trial
The large sham-controlled trial that supported FDA clearance of TMS for depression.
Read on PubMed →Archives of General Psychiatry · 2010
Daily left prefrontal TMS for major depressive disorder: a sham-controlled randomized trial
An NIH-funded trial in which active TMS produced more remissions than sham treatment.
Read on PubMed →The Lancet · 2018
Theta burst versus high-frequency rTMS in depression (THREE-D)
A 3-minute theta burst session worked as well as the standard 37-minute session, making treatment far shorter.
Read on PubMed →American Journal of Psychiatry · 2022
Stanford Neuromodulation Therapy (SNT): a double-blind randomized controlled trial
An accelerated, MRI-guided TMS protocol produced high remission rates in treatment-resistant depression within days.
Read on PubMed →Chronic pain
Clinical Neurophysiology · 2020
Evidence-based guidelines on the therapeutic use of rTMS: an update (2014–2018)
European expert guidelines rating motor-cortex rTMS among the best-supported uses for neuropathic pain.
Read on PubMed →Pain · 2013
Daily rTMS of the primary motor cortex for neuropathic pain: a multicenter, sham-controlled trial
Active stimulation provided short-term pain relief compared with sham in patients with neuropathic pain.
Read on PubMed →Brain · 2007
Effects of motor-cortex rTMS on chronic widespread pain in fibromyalgia
rTMS reduced pain and improved quality of life in patients with fibromyalgia compared with sham.
Read on PubMed →Cochrane Database of Systematic Reviews · 2018
Non-invasive brain stimulation techniques for chronic pain
A large review finding some benefit for motor-cortex rTMS, while noting that more high-quality trials are needed.
Read on PubMed →Anxiety
British Journal of Psychiatry · 2016
rTMS for generalised anxiety disorder: a randomised, double-blind, sham-controlled trial
Patients with GAD who received active rTMS had greater improvement in anxiety than those who received sham.
Read on PubMed →Brain and Behavior · 2019
TMS in anxiety and trauma-related disorders: a systematic review and meta-analysis
Pooled results across trials suggest rTMS can reduce symptoms of anxiety and trauma-related disorders.
Read on PubMed →American Journal of Psychiatry · 2019
Deep TMS for obsessive-compulsive disorder: a multicenter randomized double-blind trial
The trial behind FDA clearance of deep TMS for OCD, an anxiety-related condition.
Read on PubMed →Journal of Affective Disorders · 2019
rTMS for depression with comorbid anxiety disorders
In patients with both depression and anxiety, TMS treatment improved anxiety symptoms alongside depression.
Read on PubMed →Ketamine Therapy
Depression
Biological Psychiatry · 2000
Antidepressant effects of ketamine in depressed patients
The first controlled study showing a single ketamine dose could improve depression within hours.
Read on PubMed →Archives of General Psychiatry · 2006
A randomized trial of an NMDA antagonist in treatment-resistant major depression
A single infusion produced rapid improvement in treatment-resistant depression compared with placebo.
Read on PubMed →American Journal of Psychiatry · 2013
Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial
Ketamine outperformed an active comparator (midazolam), strengthening confidence that its benefit is real.
Read on PubMed →New England Journal of Medicine · 2023
Ketamine versus ECT for nonpsychotic treatment-resistant major depression (ELEKT-D)
Ketamine was as effective as electroconvulsive therapy for patients with treatment-resistant depression without psychosis.
Read on PubMed →Anxiety
Journal of Psychopharmacology · 2017
Ketamine’s dose-related effects on anxiety symptoms in treatment-refractory anxiety disorders
Patients with hard-to-treat anxiety reported reduced anxiety within an hour of treatment, with larger effects at higher doses.
Read on PubMed →Journal of Psychopharmacology · 2018
Maintenance ketamine in treatment-refractory generalised and social anxiety disorders
Weekly maintenance doses helped many patients sustain improvement in anxiety over several months.
Read on PubMed →Neuropsychopharmacology · 2018
Ketamine for social anxiety disorder: a randomized, placebo-controlled crossover trial
A ketamine infusion reduced social anxiety symptoms more than placebo in the following two weeks.
Read on PubMed →Neuropsychopharmacology · 2013
Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder
A single infusion rapidly reduced obsessive symptoms in unmedicated patients with OCD.
Read on PubMed →PTSD
JAMA Psychiatry · 2014
Efficacy of intravenous ketamine for chronic posttraumatic stress disorder: a randomized clinical trial
The first randomized trial showing a single ketamine infusion could rapidly reduce PTSD symptoms.
Read on PubMed →American Journal of Psychiatry · 2021
A randomized controlled trial of repeated ketamine administration for chronic PTSD
A course of six infusions over two weeks produced substantially greater PTSD improvement than an active control.
Read on PubMed →Journal of Clinical Psychiatry · 2018
Repeated ketamine infusions for comorbid PTSD and treatment-resistant depression
Veterans with both PTSD and depression saw rapid, meaningful improvement in both conditions.
Read on PubMed →Journal of Clinical Psychopharmacology · 2020
Low-dose ketamine infusion for comorbid PTSD and chronic pain: a randomized double-blind trial
Explores ketamine for patients living with both PTSD and chronic pain.
Read on PubMed →Postpartum depression
BMJ · 2024
Mini-dose esketamine for postpartum depression in women with prenatal depression: a randomized clinical trial
A single low dose after childbirth reduced the rate of postpartum depression in women who were depressed during pregnancy.
Read on PubMed →Psychiatry Research · 2019
Prophylactic use of ketamine reduces postpartum depression in women undergoing cesarean section
Low-dose ketamine given around cesarean delivery was associated with lower rates of postpartum depression.
Read on PubMed →Safety while breastfeeding
LactMed · NIH National Library of Medicine
Ketamine: Drugs and Lactation Database
The NIH’s reference summary of what is known about ketamine in breast milk and effects on nursing infants.
Read on NIH →LactMed · NIH National Library of Medicine
Esketamine: Drugs and Lactation Database
The NIH’s reference summary for esketamine (Spravato) during breastfeeding.
Read on NIH →Journal of Psychoactive Drugs · 2023
The pharmacokinetics of ketamine in the breast milk of lactating women
A small study measuring how much ketamine and its metabolites pass into breast milk after a treatment dose.
Read on PubMed →Stellate Ganglion Block (SGB)
PTSD
JAMA Psychiatry · 2020
Effect of stellate ganglion block treatment on PTSD symptoms: a randomized clinical trial
In a multisite sham-controlled trial, SGB produced significantly greater reductions in PTSD symptoms than sham over eight weeks.
Read on PubMed →Military Medicine · 2014
Stellate ganglion block for combat-related PTSD: a case series of 166 patients
Most service members treated with SGB reported clinically meaningful improvement in PTSD symptoms.
Read on PubMed →Medical Hypotheses · 2008
A unifying theory linking the prolonged efficacy of stellate ganglion block for CRPS, hot flashes, and PTSD
Explains how calming the sympathetic “fight or flight” system may account for SGB’s lasting effects.
Read on PubMed →Regional Anesthesia and Pain Medicine · 2016
Stellate ganglion block for PTSD: a randomized, double-blind, controlled trial
An earlier, smaller trial that did not find a difference from sham, part of why larger studies followed.
Read on PubMed →Rapid Relief from Suicidal Thoughts
If you or someone you love is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline, or call 911.
Ketamine & Spravato
American Journal of Psychiatry · 2018
A single dose of IV ketamine on suicidal ideation: an individual participant data meta-analysis
Pooling data from multiple trials, one ketamine dose reduced suicidal thoughts within hours, with effects lasting up to a week.
Read on PubMed →American Journal of Psychiatry · 2018
Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled trial
Ketamine reduced suicidal thoughts within 24 hours more than an active control medication.
Read on PubMed →American Journal of Psychiatry · 2018
Intranasal esketamine for rapid reduction of depression and suicidality in patients at imminent risk for suicide
Esketamine added to standard hospital care improved depressive symptoms within hours in patients at high risk.
Read on PubMed →Int. Journal of Neuropsychopharmacology · 2021
Esketamine nasal spray for patients with active suicidal ideation with intent (ASPIRE II)
A second phase 3 trial confirming rapid improvement in depressive symptoms in patients with suicidal thoughts.
Read on PubMed →TMS for OCD & Teens
Obsessive-compulsive disorder
Journal of Psychiatric Research · 2013
rTMS for OCD: a meta-analysis of randomized, sham-controlled trials
Across controlled trials, active rTMS reduced OCD symptoms more than sham stimulation.
Read on PubMed →Journal of Psychiatric Research · 2021
Real-world efficacy of deep TMS for OCD: data from twenty-two clinical sites
Results from everyday clinical practice closely matched the trial that led to FDA clearance.
Read on PubMed →Adolescents
European Child & Adolescent Psychiatry · 2022
TMS for adolescent depression: a systematic review and meta-analysis
Across studies, teens treated with TMS showed meaningful improvement in depression and tolerated treatment well.
Read on PubMed →J. Am. Academy of Child & Adolescent Psychiatry · 2021
Left prefrontal TMS for treatment-resistant depression in adolescents: a sham-controlled trial
Teens improved substantially and treatment was safe, though the sham group also improved, a common challenge in adolescent studies.
Read on PubMed →Bipolar Depression
Ketamine & TMS
Archives of General Psychiatry · 2010
A randomized add-on trial of an NMDA antagonist in treatment-resistant bipolar depression
Ketamine added to mood stabilizers rapidly improved depression in patients with bipolar disorder.
Read on PubMed →Biological Psychiatry · 2012
Replication of ketamine’s antidepressant efficacy in bipolar depression
A second controlled trial confirmed ketamine’s rapid benefit in bipolar depression.
Read on PubMed →Neuropsychopharmacology · 2017
Treatment of bipolar depression with deep TMS: a sham-controlled clinical trial
Patients receiving active deep TMS had greater improvement in bipolar depression than those receiving sham.
Read on PubMed →Journal of Affective Disorders · 2016
Efficacy and safety of rTMS in acute bipolar depression: a meta-analysis
Pooled results suggest rTMS may help bipolar depression without a meaningful increase in switching to mania.
Read on PubMed →Psilocybin: On the Horizon
Psilocybin is not yet FDA-approved and is not currently legal for clinical use. Lucid Therapeutics plans to offer psilocybin therapy next year, pending FDA approval.
Depression
New England Journal of Medicine · 2022
Single-dose psilocybin for a treatment-resistant episode of major depression
A large trial of COMP360 psilocybin found that a single 25 mg dose reduced depression more than a 1 mg dose at three weeks.
Read on PubMed →JAMA · 2023
Single-dose psilocybin treatment for major depressive disorder: a randomized clinical trial
One psilocybin session with psychological support produced rapid, sustained improvement compared with an active placebo.
Read on PubMed →JAMA Psychiatry · 2021
Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial
Two psilocybin sessions with therapy led to large, rapid reductions in depression.
Read on PubMed →New England Journal of Medicine · 2021
Trial of psilocybin versus escitalopram for depression
Compared psilocybin with a common antidepressant; both helped, with several measures favoring psilocybin.
Read on PubMed →