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Mehala Subramaniapillai

15 papers in the library · 1,374 citations · publishing 2018-2023

Papers

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Dextromethorphan-Bupropion for the Treatment of Depression: A Systematic Review of Efficacy and Safety in Clinical Trials.

CNS Drugs October 1, 2023 Dania Akbar, Taeho Greg Rhee, Felicia Ceban et al.

A significant proportion of adults with major depressive disorder (MDD) do not respond to treatments which are currently used in clinical practice such as first-generation monoamine-based antidepressants. The objective of this systematic review was to assess the efficacy, safety, and mechanisms of action of AXS-05, a combination of the NMDA-receptor antagonist dextromethorphan with bupropion,...

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...

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...

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...

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 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...

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...

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...