New Anxiety & Depression Treatments 2024-2025

Mental health treatment has seen remarkable advances in 2024 and 2025, with several genuinely innovative therapies receiving approval. From the first monotherapy for treatment-resistant depression to FDA-cleared digital therapeutics and new antidepressants with novel mechanisms, these developments offer real hope for people who've struggled to find effective treatment.

Spravato: Now Available as Monotherapy

The most significant development came in January 2025 when Spravato (esketamine) nasal spray became the first and only monotherapy for treatment-resistant depression in adults. Previously, Spravato could only be prescribed alongside an oral antidepressant, but the new approval allows it to be used alone for people who haven't responded to at least two different antidepressants.

Esketamine works through a completely different mechanism than traditional antidepressants. Rather than targeting serotonin, it affects the glutamate system in the brain. Clinical trials showed Spravato met its primary endpoint at four weeks and demonstrated rapid improvement in depressive symptoms as early as 24 hours after the first dose.

For approximately one-third of adults with major depressive disorder who don't respond to oral antidepressants, this represents a game-changing alternative. The ability to use Spravato as monotherapy is particularly valuable for people who can't tolerate oral antidepressants or have medical contraindications.

Spravato must be administered in a healthcare setting under supervision due to potential side effects including dissociation and sedation. After administration, patients are monitored for at least two hours. Whilst this requires clinic visits, the rapid and substantial improvement many patients experience makes it worthwhile.

Digital Therapeutics: FDA-Cleared Apps for Anxiety

In September 2024, the FDA cleared DaylightRx, the first prescription digital therapeutic for generalised anxiety disorder (GAD) in adults aged 22 and older. This smartphone-based app delivers cognitive behavioural therapy and is prescribed by healthcare providers as an adjunct to usual care.

Clinical trials showed impressive results, with over 70% remission rates and significantly reduced anxiety lasting six months or more. The treatment demonstrated a large effect size, with improvements in worry, depressive symptoms, sleep quality, and overall wellbeing.

DaylightRx represents a new category of treatment that increases access to evidence-based psychological therapy. For people unable to access traditional face-to-face CBT due to cost, waiting lists, or geographical barriers, prescription digital therapeutics offer a validated alternative.

Similarly, Rejoyn received FDA clearance in April 2024 as the first prescription digital treatment for major depressive disorder, though it showed more modest effects in trials. The 2025 Medicare Physician Fee Schedule includes proposals to reimburse FDA-cleared digital mental health treatments, potentially establishing sustainable access.

Exxua: A New Class of Antidepressant

After nearly two decades of development, Exxua (gepirone) received FDA approval in September 2023 and launched in 2024. It's the first oral selective 5-HT1A receptor agonist approved for major depressive disorder, representing a genuinely new mechanism of action.

Exxua targets the serotonin 1A receptor specifically, which regulates mood and emotion. Crucially, it avoids common side effects of traditional antidepressants including sexual dysfunction and weight gain. Clinical trials showed particular effectiveness in anxious depression – depression accompanied by significant anxiety symptoms.

For people who've struggled with intolerable side effects from SSRIs or SNRIs, Exxua offers an alternative that works differently. The medication is taken daily and typically requires 2-4 weeks to show therapeutic effects, similar to traditional antidepressants.

Emerging Treatments on the Horizon

LSD-based medication MM-120 (lysergide d-tartrate) received FDA breakthrough therapy designation in March 2024 for generalised anxiety disorder. Phase 2 trials showed that a single oral dose led to clinically and statistically significant reduction in GAD symptoms lasting through 12 weeks. Phase 3 trials launched in late 2024.

The FDA has also accepted a new drug application for combination therapy of sertraline and brexpiprazole for PTSD, with a decision expected in early 2025. This combination demonstrated statistically significant reductions in PTSD symptoms without requiring supplemental psychotherapy.

Accessing New Treatments in the UK

Availability varies in the UK. Spravato is licensed but access through NHS is limited to specialist centres. Private psychiatric services can prescribe it more readily, though treatment costs are significant due to the supervised administration requirement.

Exxua availability in the UK depends on obtaining a UK marketing authorisation. Private psychiatrists may prescribe it on a named-patient basis. Digital therapeutics like DaylightRx are primarily US-focused currently, though similar apps may become available in the UK.

Your NHS GP can prescribe standard antidepressants and provide mental health service referrals. For access to newer treatments, private psychiatric consultation offers more options. Online GP services can assess depression and anxiety, prescribe conventional medications, and arrange specialist psychiatry referrals when needed.

What This Means for Patients

These new treatments expand options for people who haven't responded to conventional therapy. Treatment-resistant depression affects millions, and having alternatives with different mechanisms of action means more people can find effective relief.

Digital therapeutics democratise access to evidence-based psychological treatment. Prescription apps don't replace traditional therapy but can fill gaps, particularly for mild to moderate symptoms or when in-person treatment isn't accessible.

If your current treatment isn't working well, don't assume you're out of options. Newer medications, digital therapeutics, and emerging treatments offer real alternatives. Discuss these with your GP or psychiatrist, and consider private consultation if NHS access to newer treatments is limited.

Frequently Asked Questions

How is Spravato different from regular antidepressants?

Spravato (esketamine) works on the glutamate system rather than serotonin, offering a completely different mechanism. It works much faster than traditional antidepressants, often showing improvement within 24 hours rather than weeks. However, it requires supervised administration in a healthcare setting and can't be taken at home like oral medications. It's specifically for treatment-resistant depression in people who've failed at least two oral antidepressants.

Are digital therapeutics like DaylightRx as effective as traditional therapy?

Clinical trials of DaylightRx showed over 70% remission rates for GAD, which compares favourably to traditional CBT. However, they work best as adjuncts to usual care rather than replacements. Digital therapeutics increase access to evidence-based psychological treatment and work well for motivated patients who can engage with smartphone-based programmes. They're FDA-cleared prescription treatments, not wellness apps.

Can I get Exxua on the NHS?

Exxua currently doesn't have UK marketing authorisation, so NHS prescribing isn't yet possible. Private psychiatrists may prescribe it on a named-patient basis. If it receives UK approval, NHS access would depend on NICE guidance and local formulary decisions. For now, traditional antidepressants remain the primary NHS option, with private services offering broader access to newer medications.

What if I've tried multiple antidepressants and nothing works?

Treatment-resistant depression affects approximately one-third of people with major depressive disorder. Options include switching to medications with different mechanisms (like Exxua or Spravato), augmentation strategies (adding a second medication to boost effectiveness), psychological therapies (particularly CBT), brain stimulation treatments (rTMS, ECG), and addressing underlying factors (sleep, physical health, social circumstances). Specialist psychiatric assessment is crucial.

How much does Spravato treatment cost privately?

Private Spravato treatment typically costs £600-£1,000+ per session, including the medication and supervised administration. Initial treatment involves twice-weekly sessions for four weeks, then weekly sessions, then potentially monthly maintenance. Total costs can be substantial, though for people with severe treatment-resistant depression, the potential for rapid, significant improvement may justify the investment. Some health insurance policies may cover it.

Are anxiety and depression treatments improving?

Yes, significantly. New medications target different brain systems, offering alternatives when traditional treatments fail. Digital therapeutics increase access to evidence-based psychological treatment. Emerging therapies like psychedelic-assisted treatments show promise. However, conventional treatments (SSRIs, SNRIs, CBT) remain effective first-line options for most people. The expanding toolkit means more personalised, effective treatment matching.

Struggling with anxiety or depression and want to explore the latest treatment options? The Online GP can assess your mental health, prescribe appropriate medications, and arrange specialist psychiatry referrals when needed.

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