Nature Medicine
July 1, 2024
Paul Glue, Colleen Loo, Johnson Fam et al.
60 citations
An extended-release oral tablet form of ketamine (R-107) was effective, safe, and well tolerated for treatment-resistant depression. In a phase 2 trial, 231 adults with severe depression took 120 mg of R-107 daily for 5 days; 168 who responded were then randomly assigned to receive 30, 60, 120, or 180 mg of R-107 or placebo twice weekly for 12 weeks. The 180 mg dose produced a significantly greater reduction in depression scores than placebo, with a mean difference of 6.1 points on the MADRS scale. Relapse rates dropped from 70.6% with placebo to 42.9% with 180 mg. No blood pressure changes occurred, and sedation or dissociation were minimal. Most dosing took place at home.
The Australian and New Zealand journal of psychiatry
February 1, 2024
Anthony Rodgers, Dilara Bahceci, Christopher G. Davey et al.
8 citations
The repurposing of generic racemic ketamine for severe depression has been delayed and uncoordinated for over 20 years due to insufficient commercial incentives, while a patented intranasal formulation (Spravato) gained widespread registration through substantial commercial investment. Spravato costs $600-$900 per dose compared to about $5 per dose for generic ketamine, and an annual government investment of approximately AUD$100 million in Australia was rejected twice, leaving the treatment largely inaccessible. Emerging evidence suggests generic ketamine is at least as effective as Spravato, but no comparative trials have been conducted. Without systemic reforms—including commercial incentives, public funding, reduced regulatory barriers, and coordinated international support—this pattern will repeat with new psychedelic treatments.
Journal of Psychiatric Research
July 1, 2026
Malcolm Hopwood, David Codyre, David Barton et al.
In a post-hoc subgroup analysis of an Early Access Program in Australia and New Zealand, 28 of 84 participants (33.3%) with treatment-resistant depression who received esketamine nasal spray plus a newly-initiated oral antidepressant over 16 weeks were classified as responders (≥50% decrease in HAMD-17 score). Responders showed mean improvements in depression severity (71.2%), quality of life (29.5% on AQoL-8D), and work productivity (≥11.9% on WPAI:SHP), with the largest gains in mental health (32.9%) and overall work productivity loss (35.9%). Results should be interpreted cautiously due to the post-hoc design, short follow-up, small sample, and missing data.
October 10, 2022
Malcolm Hopwood
Several drugs previously known as illicit party substances—ketamine, medicinal cannabis, MDMA, psilocybin, and DMT—are being investigated as therapies for mental illness. The text argues that these treatments should continue to undergo proper clinical trials rather than being adopted prematurely. Mental health disorders are a growing cause of disability, and these novel therapies offer potential new options, but rigorous evaluation remains essential.
Journal of Traumatic Stress
October 1, 2003
David Forbes, Andrea J Phelps, Anthony F McHugh et al.
Australian Vietnam veterans with chronic combat-related PTSD who received six weekly sessions of Imagery Rehearsal Therapy showed significant reductions in nightmare frequency and intensity that were maintained 12 months after treatment. Improvements in overall PTSD, depression, anxiety, and broader symptoms also persisted to the 12-month follow-up. The findings provide preliminary evidence that the positive effects of IRT on posttraumatic nightmares and related symptoms are durable over the longer term.