Background: Due to the increasing global prevalence of Alzheimer’s dementia (AD), neuromodulation techniques such as transcranial direct current stimulation (tDCS) and photobiomodulation (PBM) are considered potential complementary therapies. Objective: We assessed the efficacy and safety of tDCS and PBM and their potential to enhance cognitive functions in individuals with AD. Methods: This review primarily examined studies designed to evaluate the efficacy, followed by an assessment of the safety of tDCS and PBM for people with AD. The databases searched were PubMed, Scopus, and Web of Science Core Collection, resulting in 17 published randomized and controlled trials. References were screened over 5 years (2020–2024). The research design used PRISMA guidelines. Results: Fourteen studies were considered for tDCS, and the current literature supports efficacy and safety at an amperage of 2 mA, with electrodes placed on the dorsolateral prefrontal cortex (DLPFC). Three studies were included for PBM. The heterogeneity of these study measures made them unsuitable for combined efficacy analysis, and they did not provide a safety evaluation. Conclusions: Despite differences in efficacy assessments, tDCS and PBM improved cognitive abilities. There is an urgent need to standardize metrics for evaluating efficacy and safety, particularly for PBM. Future research is encouraged.

Background/Objective: Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique with growing relevance in psychiatry. Its ability to measure cortical hemodynamics positions it as a potential tool for monitoring neurofunctional changes related to treatment. However, the specific features and level of consistency of its use in clinical psychiatric settings remain unclear. A scoping review was conducted under PRISMA-ScR guidelines to systematically map how fNIRS has been used in monitoring treatment response among individuals with psychiatric disorders. Methods: Forty-seven studies published between 2009 and 2025 were included based on predefined eligibility criteria. Data was extracted on publication trends, research design, sample characteristics, fNIRS paradigms, signal acquisition, preprocessing methods, and integration of clinical outcomes. Reported limitations and conflicts of interest were also analyzed. Results: The number of publications increased sharply after 2020, predominantly from Asia. Most studies used experimental designs, with 31.9% employing randomized controlled trials. Adults were the primary focus (93.6%), with verbal fluency tasks and DLPFC-targeted paradigms most common. Over half of the studies used high-density (>32-channel) systems. However, only 44.7% reported motion correction procedures, and 53.2% did not report activation direction. Clinical outcome linkage was explicitly stated in only 12.8% of studies. Conclusions: Despite growing clinical interest, with fNIRS showing promise as a non-invasive neuroimaging tool for monitoring psychiatric treatment response, the current evidence base is limited by methodological variability and inconsistent outcome integration. There is a rising need for the adoption of standardized protocols for both design and reporting. Future research should also include longitudinal studies and multimodal approaches to enhance validity and clinical relevance.

Background/Objectives: Transcranial magnetic stimulation (TMS) is a non-invasive and well-tolerated treatment, offering an effective alternative for elderly patients with depression, especially when side effects or comorbidities limit medication. Methods: This scoping review analyzes 16 studies published over the past seven years, to evaluate the efficacy, safety, and clinical applications of TMS in older adults with depression. Results: The review examines various TMS modalities, including repetitive TMS (rTMS), deep TMS, and theta burst stimulation (TBS), with most protocols targeting the dorsolateral prefrontal cortex (DLPFC). Adverse effects were rare, mild, and transient, supporting the treatment’s safety profile. Pharmacological co-treatment was common but not essential for clinical improvement, highlighting TMS’s potential as a standalone therapy. A subset of studies used neuroplasticity (SICI, ICF, CSP) or neuroimaging measures (MRI and MRI-based neuronavigation), revealing that age-related cortical inhibition may limit plasticity rather than depression itself. Conclusions: Overall, TMS demonstrates promising effectiveness and tolerability in managing late-life depression. Across studies, remission rates varied from 20% to 63%, with higher efficacy generally observed in bilateral stimulation or high-frequency protocols. Standardization of protocols and further research into individualized targeting and long-term outcomes are warranted to support broader clinical adoption.

Background/Objectives: Therapeutic drug monitoring (TDM) of antipsychotic medications plays an important role in optimizing treatment efficacy, reducing adverse effects, and supporting adherence. While Ultra-High Performance Liquid Chromatography–Tandem Mass Spectrometry (UHPLC–MS/MS) has long been the gold standard for antipsychotic quantification, recent advances in automated platforms and microsampling raise questions about its current clinical practicality. This systematic review evaluated the clinical applicability and analytical performance of UHPLC-based methods for monitoring antipsychotic drugs, focusing on precision, recovery, matrix effects, and suitability across various biological matrices. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between 2013 and 2024 involving UHPLC-based quantification of antipsychotics in clinical samples from adult patients. Data on analytical parameters, sample matrices, and study characteristics were extracted. A custom quality checklist was used to assess methodological rigor. In addition to qualitative synthesis, non-traditional quantitative approaches were applied, including descriptive aggregation of recovery, matrix effects, and precision across studies, as well as correlation analyses to explore relationships among performance parameters. Results: Twelve studies were included, spanning a range of typical and atypical antipsychotics and metabolites. Plasma and serum demonstrated the highest analytical reliability (recovery >90%, minimal matrix effects), while dried blood spots (DBSs), whole blood, and oral fluid showed greater variability. Clinically, UHPLC–MS/MS enabled more accurate dose adjustments and identification of non-adherence, outperforming immunoassays in sensitivity, specificity, and metabolite detection. Microsampling methods showed promise for outpatient and decentralized care but require further clinical validation. Conclusions: UHPLC–MS/MS remains the most robust and reliable method for TDM of antipsychotics, especially when quantification of active metabolites is required. While logistical barriers remain, technological advances may enhance feasibility and support broader integration into routine psychiatric care.

Background: Phototherapy, which has traditionally been used for seasonal affective disorder, is now being investigated for its effectiveness in treating non-seasonal depression. This systematic review aims to evaluate the efficacy and safety of phototherapy in this new context, providing a comprehensive overview of its therapeutic potential and limitations. Methods: The review followed PRISMA guidelines and included studies from databases such as Google Scholar, PubMed, and UpToDate. Studies were selected based on their focus on phototherapy’s efficacy, safety, and application methods for non-seasonal depression. Various administration methods were examined, particularly the effects of multiple daily sessions and personalized treatment plans. Results: The findings indicate that while phototherapy alone has limited effectiveness, combining it with antidepressants significantly improves outcomes. The most effective protocols featured multiple daily sessions tailored to individual patient needs, even at lower light intensities. Safety assessments have shown that phototherapy is well tolerated, with no serious side effects reported, only minor and transient reactions. Conclusions: Phototherapy appears to be a promising adjunct therapy for non-seasonal depression, offering safety and flexibility in treatment customization. It provides consistent therapeutic benefits, mainly when used in conjunction with conventional antidepressant treatments.

Background/Objectives: Electroconvulsive therapy (ECT) remains the most effective biological treatment for treatment-resistant depression. Although its efficacy has been consistently demonstrated, the influence of seizure characteristics and treatment parameters on clinical outcomes in routine practice remains incompletely understood. This study aimed to evaluate the effectiveness of seizure threshold-titrated ECT in patients with treatment-resistant depression and to describe treatment outcomes in relation to seizure expression and technical treatment variables. Methods: We conducted a retrospective naturalistic study at the Department of ECT, Dr. Gh. Preda Clinical Psychiatric Hospital, Sibiu, Romania. Consecutive patients treated with ECT for treatment-resistant depressive episodes between March 2022 and December 2025 were included. Clinical outcomes were assessed before and after treatment using the Montgomery–Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Mini-Mental State Examination (MMSE), and Global Assessment of Functioning Scale (GAF). Information regarding electrode placement, seizure threshold, seizure duration, the number of ECT sessions, and concomitant psychotropic medication was collected from medical records. Results: Nineteen acute ECT courses were available for outcome analysis. Depressive symptom severity improved significantly following treatment, with median MADRS scores decreasing from 38 (IQR 36–41) to 20 (IQR 9.5–24) (p < 0.001). A clinical response was observed in 57.9% of courses, while 36.8% achieved remission. Similar improvements were noted in self-reported depressive symptoms and overall functioning, with median BDI scores decreasing from 38 to 16 and median GAF scores increasing from 55 to 65. MMSE scores remained stable throughout treatment. Considerable variability was observed in both motor and EEG seizure durations; however, no consistent relationship between seizure duration and antidepressant response was identified. Discussion: The observed outcomes are consistent with previous evidence supporting ECT as an effective intervention for severe depressive illness. Functional improvement accompanied symptom reduction, while no decline in global cognitive performance, as assessed by the MMSE, was observed. In this cohort, seizure duration alone did not appear to provide meaningful information regarding treatment response. Conclusions: Seizure threshold-titrated ECT was associated with substantial clinical improvement in patients with treatment-resistant depressive episodes, accompanied by improved functioning and stable global cognitive performance. These findings support the continued use of individualized ECT protocols in routine clinical practice and highlight the need for further research on neurophysiological predictors of treatment outcome.