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"As far as prevention goes, the beneficial effect of ramelteon looks pretty strong, but the amount of evidence for its efficacy is actually pretty low," Dr. Peter Shapiro said.

Dr. Paul S. Appelbaum and colleague examine the multiple changes looming in both the doctor’s and the patient’s roles in the move toward precision medicine.

“Approval of esketamine is important for patients because other options like transcranial magnetic stimulation work more poorly in medication-resistant depression,” writes Dr. J. John Mann. .

When the drug works, its effect is almost immediate. That speed “is a huge thing because depressed patients are very disabled and suffer enormously,” said Dr. John Mann.