In this NEJM Double Take episode, experts discuss the critical role of neuroplasticity in depression and examine advanced treatment options for patients who do not respond to traditional therapies. Topics include the efficacy of ECT and TMS, as well as emerging evidence for ketamine, esketamine, and psilocybin.

Prehospital management of blood pressure in patients with suspected acute stroke shows varying impacts depending on the stroke type. Immediate reduction improves outcomes in hemorrhagic stroke but may worsen outcomes in ischemic stroke, emphasizing the need for tailored approaches in early stroke care.

New research suggests a link between frequent daytime napping and an increased risk of hypertension and stroke, highlighting the importance of evaluating patients’ sleep habits as part of their cardiovascular risk assessment.

Using a massage gun on the neck can significantly increase stroke risks due to potential arterial dissections. Educating patients on the dangers and encouraging professional medical evaluation for neck pain is crucial.

GLP-1 receptor agonists, beyond their role in diabetes and obesity management, are showing promise in reducing alcohol cravings, potentially offering a novel approach to treating alcohol use disorder.

Early intervention in psychosis significantly improves outcomes, highlighting the necessity for holistic, patient-centered care.