Treatment-resistant depression (TRD) is associated with severe depression, low quality of life (QoL) and reduced work productivity, which may increase risk of relapse, suicide and suboptimal response to treatment. Esketamine nasal spray plus a newly-initiated oral antidepressant (esketamine+OAD) has been shown to improve depression symptoms, QoL and productivity in patients with TRD; however...
Ketamine has rapid-onset antidepressant activity in patients with treatment-resistant major depression (TRD). The safety and tolerability of racemic ketamine may be improved if given orally, as an extended-release tablet (R-107), compared with other routes of administration. In this phase 2 multicenter clinical trial, male and female adult patients with TRD and Montgomery-Asberg Depression...
In this paper, the case study of ketamine as a new treatment for severe depression is used to outline the challenges of repurposing established medicines and we suggest potential solutions. The antidepressant effects of generic racemic ketamine were identified over 20 years ago, but there were insufficient incentives for commercial entities to pursue its registration, or support for...
Objective To review the usefulness of esketamine for treatment-resistant depression. Method Pivotal trials of intranasal esketamine in treatment-resistant depression were synthesized as a narrative review. Results Esketamine is postulated to act through antagonism of N-methyl-D-aspartate (NMDA) glutamate receptors, but opioidergic effects may also be involved. Unlike intravenous ketamine,...
Therapy is turning to drugs previously known for being illicit party substances. But there’s no reason to abandon proper trials. A range of new therapies for mental illness were previously considered unthinkable — party drugs including ketamine, medicinal cannabis and psychedelics like MDMA, psilocybin and DMT. With mental health disorders a growing cause of disability […]
Consensus on the parameters of trauma-related dreams required to meet criteria for post-traumatic stress disorder (PTSD) is critical when: (i) the diagnosis requires a single re-experiencing symptom; and (ii) trauma dreams are prevalent in survivors without PTSD. This study investigated the phenomenology of PTSD dreams in 40 veterans, using structured interview and self-report measures. Dream...
Nightmares are often a distressing symptom for veterans with chronic combat-related posttraumatic stress disorder (PTSD). A psychological treatment that has recently shown considerable promise is Imagery Rehearsal Therapy (IRT). In a pilot study by the current authors, IRT was demonstrated to be effective in the treatment of posttraumatic nightmares in a group of combat veterans up to 3-month...