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Yena Lee

University Health Network, Brain and Cognition Discovery Foundation

27 papers in the library · 2,144 citations · publishing 2015-2022

Papers

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The association between stage of treatment-resistant depression and clinical utility of ketamine/esketamine: A systematic review.

Journal of Affective Disorders December 1, 2022 Anastasia Levinta, Shakila Meshkat, Roger S McIntyre et al.

Ketamine has demonstrated rapid and significant antidepressant effects in patients with treatment resistant depression (TRD). Herein, we conducted a systematic review to determine ketamine's efficacy as a function of the stage of treatment resistance (e.g., number of failed treatments) among individuals with TRD. A systematic search of PubMed and Scopus from inception to August 2021 was...

Ketamine as Potential Treatment for Postpartum Depression: A Narrative Review

Annals of Clinical Psychiatry November 1, 2022 David C J Chen-Li, Leanna M.W. Lui, Joshua D. Rosenblat et al. 22 citations

BACKGROUND: Postpartum depression (PPD) is a severe, debilitating mood disorder with consequences for both mothers and children, highlighting the need for rapid-acting and effective treatments for PPD. The aim of this narrative review is to synthesize the available literature on the administration of ketamine for PPD and propose ketamine as a viable and advantageous treatment. METHODS: A search...

Active mechanisms of ketamine-assisted psychotherapy: A systematic review.

Journal of Affective Disorders October 15, 2022 Isak Joneborg, Yena Lee, Joshua D. Di Vincenzo et al.

Few studies have evaluated the efficacy of ketamine-assisted psychotherapy (KAP) in the treatment of treatment-resistant depression (TRD) and substance use disorders (SUD). A systematic review of clinical trials reporting on the efficacy of KAP and discussing mechanisms of action, identified on PubMed and PsycInfo. Five randomized-controlled trials reported on the efficacy of KAP treatment and...

A Research Domain Criteria (RDoC)-Guided Dashboard to Review Psilocybin Target Domains: A Systematic Review.

CNS Drugs October 1, 2022 Niloufar Pouyan, Zahra Halvaei Khankahdani, Farnaz Younesi Sisi et al. 16 citations

Preliminary results from randomized controlled studies as well as identified molecular, cellular, and circuit targets of select psychedelics (e.g., psilocybin) suggest that their effects are transdiagnostic. In this review, we exploit the Research Domain Criteria (RDoC) transdiagnostic framework, to synthesize extant literature on psilocybin. We aimed to identify RDoC-based effects of...

The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder

The Canadian Journal of Psychiatry August 17, 2022 Joshua D. Rosenblat, Muhammad Ishrat Husain, Yena Lee et al. 58 citations

Objective Serotonergic psychedelics are re-emerging as potential novel treatments for several psychiatric disorders including major depressive disorder. The Canadian Network for Mood and Anxiety Treatments (CANMAT) convened a task force to review the evidence and provide a consensus recommendation for the clinical use of psychedelic treatments for major depressive disorder. Methods A systematic...

Real-world effectiveness of ketamine in treatment-resistant depression: A systematic review & meta-analysis.

Journal of Psychiatric Research May 1, 2022 Yazen Alnefeesi, David C J Chen-Li, Ella Krane et al. 177 citations

Ketamine is a promising therapeutic option in treatment-resistant depression (TRD). The acute efficacy of ketamine in TRD has been demonstrated in replicated randomised-controlled trials (RCTs), but the generalizability of RCT data to real-world practice is limited. To this end, we conducted a systematic review (Search date: 25/12/2021; 1482 records identified) and meta-analysis of studies...

Frequency analysis of symptomatic worsening following ketamine infusions for treatment resistant depression in a real-world sample: Results from the canadian rapid treatment center of excellence.

Psychiatry Research 2022 Joshua D. Di Vincenzo, Orly Lipsitz, Nelson B Rodrigues et al. 11 citations

Antidepressants are associated with symptomatic worsening in a subgroup of patients. Replicated evidence has demonstrated rapid and robust antidepressant effects with intravenous (IV) ketamine in treatment resistant depression (TRD); however, the risk of ketamine worsening depressive symptoms in a subgroup of patients remains unknown. Herein we report a retrospective analysis on the rates of...

Molecular Mechanisms of Psilocybin and Implications for the Treatment of Depression

CNS Drugs November 17, 2021 Susan Ling, Felicia Ceban, Leanna M.W. Lui et al. 123 citations

Therapeutic deficiencies with monoaminergic antidepressants invites the need to identify and develop novel rapid-acting antidepressants. Hitherto, ketamine and esketamine are identified as safe, well-tolerated rapid-acting antidepressants in adults with treatment-resistant depression, and also mitigate measures of suicidality. Psilocybin is a naturally occurring psychoactive alkaloid and...

Ketamine for psychotic depression: An overview of the glutamatergic system and ketamine's mechanisms associated with antidepressant and psychotomimetic effects.

Psychiatry Research October 1, 2021 Tuyen T. Le, Joshua D. Di Vincenzo, Kayla M Teopiz et al. 26 citations

Approximately 0.35-1% of the general population is afflicted with psychotic depression at some time in their life. Psychotic depression is a subtype of major depressive disorder characterized by mood congruent hallucinations and/or delusions. Patients with psychotic depression often represent the most severe cases, with high relapse and mortality rate. Although treatment guidelines recommend a...

Do sleep changes mediate the anti‐depressive and anti‐suicidal response of intravenous ketamine in treatment‐resistant depression?

Journal of Sleep Research June 16, 2021 Nelson B Rodrigues, Roger S McIntyre, Orly Lipsitz et al. 28 citations

Summary Sleep disturbances are commonly reported in patients with treatment‐resistant depression (TRD). Available data have shown that intravenous (IV) ketamine is an effective treatment for patients with TRD and growing data suggest ketamine may improve overall sleep architecture. In the present study, we evaluated whether changes in sleep symptoms mediated the anti‐depressive and/or...

Strategies to Prolong Ketamine’s Efficacy in Adults with Treatment-Resistant Depression

Advances in Therapy April 30, 2021 Eric P. Mcmullen, Yena Lee, Orly Lipsitz et al.

Ketamine treatment is capable of significant and rapid symptom improvement in adults with treatment-resistant depression (TRD). A limitation of ketamine treatment in TRD is the relatively short duration of time to relapse (e.g., median 2–4 weeks). The objective of the systematic review herein is to identify strategies capable of prolonging the acute efficacy of ketamine in adults with TRD....

Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation

American Journal of Psychiatry March 17, 2021 Roger S McIntyre, Joshua D. Rosenblat, Charles B. Nemeroff et al. 694 citations

Replicated international studies have underscored the human and societal costs associated with major depressive disorder. Despite the proven efficacy of monoamine-based antidepressants in major depression, the majority of treated individuals fail to achieve full syndromal and functional recovery with the index and subsequent pharmacological treatments. Ketamine and esketamine represent...

Validation of the McIntyre And Rosenblat Rapid Response Scale (MARRRS) in Adults with Treatment-Resistant Depression Receiving Intravenous Ketamine Treatment.

Journal of Affective Disorders March 1, 2021 Roger S McIntyre, Nelson B Rodrigues, Orly Lipsitz et al. 10 citations

BACKGROUND Depression severity and efficacy measurement scales employed for rapid-acting treatments (e.g., ketamine) were initially validated in adults receiving conventional monoamine-based antidepressants. The emergence of rapid-acting antidepressants in psychiatry provides the impetus for outcome measures that have been validated as sensitive to change with rapid-acting treatments. Herein,...

A simplified 6-Item clinician administered dissociative symptom scale (CADSS-6) for monitoring dissociative effects of sub-anesthetic ketamine infusions.

Journal of Affective Disorders December 29, 2020 Nelson B Rodrigues, Roger S McIntyre, Orly Lipsitz et al.

BACKGROUND Dissociation is a treatment-emergent adverse event commonly associated with IV ketamine, often measured using the 23-item Clinician-Administered Dissociative States Scale (CADSS). The objective of this study was to develop a short form version of the CADSS for easier clinical use. METHODS Retrospective data of 260 patients with treatment-resistant depression (TRD) receiving IV...

The acute antisuicidal effects of single-dose intravenous ketamine and intranasal esketamine in individuals with major depression and bipolar disorders: A systematic review and meta-analysis.

Journal of Psychiatric Research December 11, 2020 Jiaqi Xiong, Orly Lipsitz, David C J Chen-Li et al. 122 citations

The efficacy of ketamine in reducing suicidal ideation (SI) has been previously reported. We aimed to evaluate acute anti-SI effects of single-dose ketamine in different formulations/routes of administration by pooling results from randomized controlled trials (RCTs). A systematic search was conducted on Cochrane, Embase, Medline, and PubMed from inception to July 1st, 2020. Studies were...

Effectiveness of intravenous ketamine in mood disorder patients with a history of neurostimulation

CNS Spectrums December 10, 2020 Nelson B Rodrigues, Ashley N. Siegel, Orly Lipsitz et al. 17 citations

BACKGROUND: Patients unsuccessfully treated by neurostimulation may represent a highly intractable subgroup of depression. While the efficacy of intravenous (IV) ketamine has been established in patients with treatment-resistant depression (TRD), there is an interest to evaluate its effectiveness in a subpopulation with a history of neurostimulation. METHODS: This retrospective, posthoc...

Does body mass index predict response to intravenous ketamine treatment in adults with major depressive and bipolar disorder? Results from the Canadian Rapid Treatment Center of Excellence

CNS Spectrums December 3, 2020 Orly Lipsitz, Roger S McIntyre, Nelson B Rodrigues et al. 25 citations

BACKGROUND: Higher body mass index (BMI) has been found to predict greater antidepressant response to intravenous (IV) ketamine treatment. We evaluated the association between BMI and response to repeat-dose IV ketamine in patients with treatment-resistant depression (TRD). METHODS: Adults (N = 230) with TRD received four infusions of IV ketamine at a community-based clinic. Changes in symptoms...

The Effects of Ketamine on Cognition in Treatment-Resistant Depression: A Systematic Review and Priority Avenues for Future Research.

Neuroscience and Biobehavioral Reviews November 23, 2020 Hartej Gill, Barjot Gill, Nelson B Rodrigues et al. 92 citations

Replicated evidence has documented cognitive deficits in populations with treatment-resistant depression (TRD). Approximately 40% of patients with MDD present with impairment of one or more cognitive domains. As such, there is an unmet need to discover treatments that have pro-cognitive effects in TRD patients. Ketamine has demonstrated efficacy as a rapid-onset intervention for the treatment...

The effect of intravenous, intranasal, and oral ketamine in mood disorders: A meta-analysis.

Journal of Affective Disorders November 1, 2020 Roger S McIntyre, Isabelle P. Carvalho, Leanna M.W. Lui et al. 186 citations

BACKGROUND Ketamine is established as a rapid and effective treatment in adults with treatment-resistant depression (TRD). The availability of different formulations and routes of delivery invites the need for evaluating relative effect sizes. METHODS Effect size with respect to depression symptom reduction for each formulation and route of delivery was compared at discrete time-points (i.e.,...

The effectiveness of intravenous ketamine in adults with treatment-resistant major depressive disorder and bipolar disorder presenting with prominent anxiety: Results from the Canadian Rapid Treatment Center of Excellence

Journal of Psychopharmacology October 11, 2020 Roger S McIntyre, Nelson B Rodrigues, Orly Lipsitz et al. 19 citations

Background: Individuals meeting criteria for treatment-resistant depression (TRD) are differentially affected by high levels of anxiety symptoms. Aims: There is a need to identify the efficacy of novel rapid-onset treatments in adults with mood disorders and comorbid anxious-distress. Methods: This study included patients with treatment-resistant major depressive disorder (MDD) or bipolar...

The emerging role of psilocybin and MDMA in the treatment of mental illness

Expert Review of Neurotherapeutics September 21, 2020 Hartej Gill, Barjot Gill, David C J Chen-Li et al. 62 citations

Psychedelics, such as psilocybin and MDMA, offer an alternative avenue of therapy for many mental health disorders. Available evidence indicates that psychedelics may offer a single-dose, rapid effect model that have robust effects with treatment-resistant mental disorders and a unique advantage as a possible monotherapy for mental illness. Novel clinical trials that evaluate the safety,...

Safety and tolerability of IV ketamine in adults with major depressive or bipolar disorder: results from the Canadian rapid treatment center of excellence

Expert Opinion on Drug Safety June 15, 2020 Nelson B Rodrigues, Roger S McIntyre, Orly Lipsitz et al. 50 citations

ABSTRACT Objectives Rigorous clinical trials suggest ketamine is safe and well-tolerated in patients with treatment-resistant depression (TRD). There is a paucity of data on the safety and tolerability of ketamine in community-based clinics treating patients with TRD. Methods Retrospective data was analyzed from 203 patients with TRD who received repeat-dose IV ketamine. Safety was...

The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder

Bipolar Disorders May 14, 2020 Roger S McIntyre, Orly Lipsitz, Nelson B Rodrigues et al. 64 citations

Abstract Objective To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment‐resistant major depressive disorder (MDD) or bipolar disorder (BD). Method Adults (N = 201) with treatment‐resistant MDD or BD received repeat‐dose IV ketamine treatment at a community‐based clinic. Mixed features were measured using...

Oral Ketamine for Depression

The Journal of Clinical Psychiatry April 15, 2019 Joshua D. Rosenblat, André F. Carvalho, Madeline Li et al. 111 citations

OBJECTIVE: Intravenous (IV) ketamine has rapid and robust antidepressant effects; however, poor accessibility of the IV route often limits its use. Numerous alternative routes of administration are being investigated. Oral ketamine is particularly appealing for its ease of use with the potential for high accessibility. The objective of the current systematic review, in accordance with PRISMA,...

Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

International Journal of Environmental Research and Public Health April 17, 2018 Carola Rong, Caroline Park, Joshua D. Rosenblat et al. 116 citations

OBJECTIVES: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to...