While tools from digital therapeutics to neuromodulation headsets to address mental health conditions are being developed, such offerings have not yet made it into real-world healthcare settings to the extent anticipated, according to Dr Wolfram Kawohl, chief medical officer at Swiss psychiatric hospital Clienia and professor at the University of Zurich.
Speaking with Pharmaceutical Technology's sister publication, Medical Device Network at Life Sciences Baltics 2025, which took place in Vilnius, Lithuania, on 16-18 September, Kawohl highlighted that the basic principles of therapy of severe mental disorders such as schizophrenia and severe depression remain pharmaceutical- and psychotherapeutic-based.
He said: “Along with organisations such as the APA (American Psychiatric Association), I see a big role for artificial intelligence (AI) in the support of routine and administrative processes in the daily work of nurses, doctors and therapists.
“However, digital applications and other treatment tools have not appeared as mainstays in daily routine treatment as yet, at least not to the degree expected, but they can be interesting add-ons.”
Such companies developing adjunct mental health treatments include Otsuka Precision Health and Click Therapeutics with Rejoyn, a prescription digital therapeutic (DTx) for the adjunctive treatment of major depressive disorder (MDD) symptoms, which was launched in the US last year.
According to GlobalData analysis, the global digital health market is set to reach a valuation of around $23.5bn by 2034, up from $7bn in 2024.
Other more involved solutions to address conditions such as treatment-resistant depression (TRD) are in development. In March, Abbott initiated its pivotal trial evaluating the efficacy of its deep-brain stimulation (DBS) implant in treating TRD.
At Clienia, Kawohl shared that the hospital has experimented with blended therapy for inpatients and outpatients, involving a combination of personally delivered psychotherapy and app-based therapies. One such platform teaches individuals to do Jacobson muscular relaxation, how to sleep better, or how to improve their self-esteem.
Across the wider digital therapy landscape, however, Kawohl highlighted that there is the ongoing issue of there being little in the way of reimbursement at this time for these treatments in many countries, save for limited examples such as Germany's Digital Health Applications (DiGA) initiative.
Ketamine and marijuana-based treatments “evolution, not revolution”
Kawohl also discussed the potential of alternative pharmacologic approaches to treating certain mental health conditions, such as with the use of ketamine infusions or marijuana (cannabis).
He conceded that to him and many of his colleagues, such options do not represent a revolution in the approach to psychiatric care.
Kawohl said: “They [ketamine/cannabis] just expand our arsenal, which is good, because not every patient profits from the therapies we have.
“Generally, these options are not first-line treatments, although ketamine can be a good treatment for TRD. We use it in our outpatient facilities, mostly, but also in our inpatient facilities."
Kawohl concluded by calling for tempered expectations for these treatment modalities against bold claims made in the media.
He added: "If you look at the media coverage concerning treatments like this, you get the impression they are going to change everything. I wouldn't bet on that; it's not going to change everything; it's just a further step, or add-on, but an interesting and important one."
