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Flávia Vieira

10 papers in the library · 585 citations · publishing 2018-2025

Papers

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Measuring suicidal behavior in the era of rapid-acting antidepressants: A systematic review of ketamine studies.

Psychiatry Research June 1, 2025 Flávia Vieira, Ana Teresa Caliman-Fontes, Breno Souza-Marques et al.

Assessment measures for suicidal behavior range from depression scales to longer suicide-specific instruments. In this review, we systematically summarize and discuss the currently used instruments for assessing suicidal behavior in the context of ketamine and its enantiomers. We searched Medline/PubMed, Embase, and PsycINFO databases for ketamine (and its enantiomers) human studies exploring...

Does the intensity of dissociation predict antidepressant effects 24 hours after infusion of racemic ketamine or esketamine in treatment-resistant depression? A secondary analysis from a randomized controlled trial

Trends in Psychiatry and Psychotherapy May 27, 2025 Mariana V F Echegaray, Rodrigo P Mello, Guilherme M. Magnavita et al. 11 citations

Abstract Objective Ketamine and esketamine have both shown significant antidepressant effects in treatment-resistant depression (TRD) and conflicting evidence suggests that dissociation induced by these drugs could be a clinical predictor of esketamine/ketamine's efficacy. Methods This study is a secondary analysis of data from a two-center, randomized, controlled trial. Participants were...

Ketamine for catatonia: A novel treatment for an old clinical challenge? A systematic review of the evidence.

Schizophrenia Research September 1, 2024 Ana Teresa Caliman-Fontes, Flávia Vieira, Gustavo C. Leal et al. 7 citations

Catatonia, documented since the 19th century, remains a significant challenge in terms of recognition and treatment. Over the last two decades, ketamine has brought new perspectives to psychiatry, sparking widespread interest. Concurrently, catatonia has attracted heightened scientific attention. Preliminary evidence suggests the therapeutic potential of ketamine for catatonia. We...

Arketamine for bipolar depression: Open-label, dose-escalation, pilot study.

Journal of Psychiatric Research August 1, 2023 Igor D. Bandeira, Gustavo C. Leal, Fernanda S. Correia-Melo et al.

There are significantly fewer options for the treatment of bipolar depression than major depressive disorder, with an urgent need for alternative therapies. In this pilot study, we treated six subjects with bipolar disorder types I and II (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria) who had been in a current depressive episode for at...

Arketamine as adjunctive therapy for treatment-resistant depression: A placebo-controlled pilot study.

Journal of Affective Disorders June 1, 2023 Gustavo C. Leal, Breno Souza-Marques, Rodrigo P Mello et al.

Racemic ketamine is a mixture of (R)-ketamine (arketamine) and (S)-ketamine (esketamine), with the latter regarded as the main isomer for antidepressant effects. However, preclinical data and one open-label human trial suggest arketamine might exert a more potent and longer-lasting antidepressant effect with fewer side effects. We aimed to explore the feasibility of a randomized controlled...

Clinical predictors of depressive symptom remission and response after racemic ketamine and esketamine infusion in treatment‐resistant depression

Human Psychopharmacology February 18, 2022 A. P. Jesus-Nunes, Gustavo C. Leal, Fernanda S. Correia-Melo et al. 39 citations

Major depressive disorder (MDD) is a leading cause of disability worldwide and most people do not achieve symptom remission. Treatment‐resistant depression (TRD) is characterized by the failure of at least one adequate trial of a major class of antidepressant, with adequate time and dosage. We aimed to identify clinical predictors of depressive symptom remission and response 24 h and 7 days...

Trait dissociation as a predictor of induced dissociation by ketamine or esketamine in treatment-resistant depression: Secondary analysis from a randomized controlled trial.

Journal of Psychiatric Research May 8, 2021 Rodrigo P Mello, Mariana V F Echegaray, A. P. Jesus-Nunes et al. 22 citations

Dissociative symptoms are common, possibly severe, side effects associated with the use of ketamine and esketamine in depression. We investigated the relationship between trait dissociation and dissociation induced by ketamine and esketamine used as augmentation therapy in treatment-resistant depression (TRD). Adults with TRD were randomly assigned to receive a single intravenous infusion, with...

Intravenous arketamine for treatment-resistant depression: open-label pilot study

European Archives of Psychiatry and Clinical Neuroscience February 20, 2020 Gustavo C. Leal, Igor D. Bandeira, Fernanda S. Correia-Melo et al. 257 citations

We aimed to analyze the efficacy and safety of arketamine, the R (−)-enantiomer of ketamine, for treatment-resistant depression (TRD) in humans. Open-label pilot trial, seven subjects with TRD received a single intravenous infusion of arketamine (0.5 mg/kg); primary outcome was change in Montgomery–Åsberg Depression Rating Scale (MADRS) 24 h after. Mean MADRS dropped from 30.7 before infusion...

Efficacy and safety of adjunctive therapy using esketamine or racemic ketamine for adult treatment-resistant depression: A randomized, double-blind, non-inferiority study.

Journal of Affective Disorders November 14, 2019 Fernanda S. Correia-Melo, Gustavo C. Leal, Flávia Vieira et al. 188 citations

BACKGROUND Ketamine and its enantiomers have recently been highlighted as one of the most effective therapeutic options in refractory depression. However, racemic ketamine and esketamine have not been directly compared. The aim of this study is to assess the efficacy and safety of esketamine compared to ketamine in patients with treatment-resistant depression (TRD). METHODS This is a...

Comparative study of esketamine and racemic ketamine in treatment-resistant depression

Medicine September 1, 2018 Fernanda S. Correia-Melo, Gustavo C. Leal, Michelle S. Carvalho et al. 61 citations

INTRODUCTION: The use of ketamine as an option in the treatment of depressive disorder is growing rapidly, supported by numerous clinical trials attesting its efficacy and safety. Esketamine, the S (+) enantiomer of ketamine, is the most widely used form in the anesthetic environment in some countries, and new studies have shown that it may also be effective in depression and with better...