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Angela T H Kwan

17 papers in the library · 161 citations · publishing 2023-2026

Papers

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The effect of glutamatergic modulators on sleep behavior and architecture in depressive disorders: A systematic review.

Journal of Psychiatric Research June 1, 2026 Kyle Valentino, Hana Ballum, William Cheung et al.

Approximately 80% of individuals diagnosed with major depressive disorder (MDD) report symptoms of insomnia. Glutamatergic modulators, such as ketamine, are reported to be effective for the treatment of depressive symptomatology in adults with MDD. Disrupted glutamate homeostasis is linked to poor sleep quality and sleep disorders. Herein, we sought to systematically determine the effect of...

Effect of Ketamine on Reward Processing in Depressive Disorders: A Systematic Review of Neuroimaging Studies

CNS Spectrums March 10, 2026 Halima Faisal, Gia Han Le, Angela T H Kwan et al.

Background: Anhedonia and reward-processing deficits are core features of major depressive disorder (MDD) that respond poorly to traditional antidepressants.Ketamine has rapid antidepressant effects, yet its neurofunctional actions within reward circuits remain unclear.We synthesized human neuroimaging evidence on ketamine-related modulation of reward circuitry and implications for...

Abuse liability of dextromethorphan and its combinatory formulation dextromethorphan/bupropion: a pharmacologic perspective.

Expert Opinion on Drug Metabolism & Toxicology 2026 Yang Jing Zheng, Christine E. Dri, Sabrina Wong et al.

Dextromethorphan/Buproprion (DXM/BUP) has received breakthrough FDA approval in August 2022 as a rapid-acting antidepressant. DXM/BUP is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist and sigma-1 receptor agonist, with bupropion (BUP), a norepinephrine/dopamine reuptake inhibitor and cytochrome P450 2D6 (CYP2D6) inhibitor. As DXM/BUP moves closer to widespread clinical use for...

A Global Population-Based Study on the Association Between Ketamine and Esketamine With Suicidality Using WHO VigiBase.

The Journal of Clinical Psychiatry July 7, 2025 Angela T H Kwan, Moiz Lakhani, Joshua D. Rosenblat et al. 2 citations

Background: Ketamine and esketamine have been reported to rapidly alleviate various parameters of suicidality, with antisuicidal effects that may be independent of their rapid-acting antidepressant effects. However, it remains unclear whether ketamine and/or esketamine are associated with the emergence or worsening of suicidality. Methods: In this global observational pharmacovigilance cohort...

The sigma-1 receptor: a mechanistically-informed therapeutic target for antidepressants.

Expert Opinion on Therapeutic Targets June 1, 2025 Naomi Xiao, Liyang Yin, Kayla M Teopiz et al. 5 citations

The mechanism of action of antidepressants is not fully ascertained. In addition to monoamines, disparate other effectors are also implicated in the molecular and cellular effects of chronic stress including neurogenesis, neurodifferentiation, and neuroplasticity. Evidence suggests sigma-1 receptors (S1Rs) as a putative target and possible mediator of antidepressant activity. Data from...

Hepatic adverse events associated with ketamine and esketamine: A population-based disproportionality analysis.

Journal of Affective Disorders April 1, 2025 Angela T H Kwan, Moiz Lakhani, Kayla M Teopiz et al. 11 citations

To determine whether there is disproportionate reporting of hepatobiliary disorders in the United States (US) FDA Adverse Event Reporting System (FAERS) for individuals prescribed ketamine or esketamine. We identified Medical Dictionary for Regulatory Activities (MedDRA) terms in the FAERS related to hepatobiliary disorders. Formulations of ketamine and esketamine were evaluated for the...

Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research.

The American journal of psychiatry 2025 Roger S McIntyre, Angela T H Kwan, Rodrigo B. Mansur et al. 23 citations

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain psychedelics are effective and safe in the treatment of major depressive disorder, treatment-resistant depression, and posttraumatic stress disorder....

Effects of ketamine on metabolic parameters in depressive disorders: A systematic review.

Journal of Affective Disorders December 15, 2024 Sabrina Wong, Gia Han Le, Rodrigo B. Mansur et al. 3 citations

Persons with Major Depressive Disorder (MDD), notably treatment-resistant depression (TRD), are differentially affected by type 2 diabetes mellitus and associated morbidity. Ketamine is highly efficacious in the treatment of adults living with MDD, notably TRD. Herein, we sought to determine the effect of ketamine on metabolic parameters in animal stress paradigms and human studies. We...

Ketamine for the Treatment of Psychiatric Disorders: A Systematic Review and Meta-Analysis.

CNS Spectrums November 20, 2024 Angela T H Kwan, Moiz Lakhani, Gurkaran Singh et al. 4 citations

Inadequate response to first- and second-line pharmacological treatments for psychiatric disorders is commonly observed. Ketamine has demonstrated efficacy in treating adults with treatment-resistant depression (TRD), with additional off-label benefits reported for various psychiatric disorders. Herein, we performed a systematic review and meta-analysis to examine the therapeutic applications...

Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis.

CNS Spectrums October 31, 2024 Sabrina Wong, Gia Han Le, Angela T H Kwan et al. 10 citations

Postpartum depression (PPD), now referred to as perinatal depression, is a prevalent and debilitating mood disorder that reduces health-related quality of life (HRQoL) and psychosocial functioning. Esketamine, which is efficacious in adults with treatment-resistant depression and individuals with depression and suicidality, is also analgesic in pain management during childbirth labour. Herein,...

A replication study using the World Health Organization pharmacovigilance database (VigiBase®) to evaluate whether an association between ketamine and esketamine and alcohol and substance misuse exists.

Journal of Affective Disorders October 15, 2024 Angela T H Kwan, Joshua D. Rosenblat, Rodrigo B. Mansur et al. 13 citations

Ketamine and esketamine are increasingly prescribed in the treatment of resistant mood disorders and persons at risk of suicide. Ketamine is a drug of misuse with increasing non-therapeutic use in the general population. Herein, our aim was to determine whether ketamine and/or esketamine are disproportionately associated with reports of substance and/or alcohol misuse. Replicating a similar...

The association between ketamine and esketamine with alcohol and substance misuse: Reports to the Food and Drug Administration adverse event reporting system (FAERS).

Journal of Affective Disorders September 1, 2024 Angela T H Kwan, Joshua D. Rosenblat, Rodrigo B. Mansur et al. 8 citations

Ketamine and esketamine have been proven to be effective in treating adults with treatment resistant depression (TRD). Preliminary evidence indicates that, when combined with behavioral and psychological interventions, both agents may offer benefits for individuals with substance use disorder (SUD) and alcohol use disorder (AUD). Notwithstanding, concerns have been raised as to whether either...

Number needed to treat (NNT) for ketamine and esketamine in adults with treatment-resistant depression: A systematic review and meta-analysis.

Journal of Affective Disorders July 1, 2024 Cameron N Calder, Angela T H Kwan, Kayla M Teopiz et al. 31 citations

Ketamine has been established as efficacious in adults living with Treatment-resistant Depression (TRD). Toward providing a quantifiable estimate of the clinical meaningfulness of the therapeutic benefit of ketamine, herein, we conduct a systematic review that aims to report the Number Needed to Treat (NNT) and the Number Needed to Harm (NNH). This systematic review searched Embase,...

The association between ketamine and esketamine and suicidality: reports to the Food And Drug Administration Adverse Event Reporting System (FAERS).

Expert Opinion on Drug Safety June 21, 2024 Roger S McIntyre, Rodrigo B. Mansur, Joshua D. Rosenblat et al. 7 citations

Replicated evidence indicates that ketamine and esketamine reduce measures of suicidality in persons with treatment-resistant depression (TRD). It remains uncertain whether individuals experience worsening of preexisting suicidality with either agent. The Food and Drug Administration Adverse Event Reporting System (FAERS) database was searched from 1970 and 2019 to 30 September 2023 for reports...

Spectral signatures of psilocybin, lysergic acid diethylamide (LSD) and ketamine in healthy volunteers and persons with major depressive disorder and treatment-resistant depression: A systematic review.

Journal of Affective Disorders June 15, 2024 Gia Han Le, Sabrina Wong, Sebastian Badulescu et al. 25 citations

Electrophysiologic measures provide an opportunity to inform mechanistic models and possibly biomarker prediction of response. Serotonergic psychedelics (SPs) (i.e., psilocybin, lysergic acid diethylamide (LSD)) and ketamine represent new investigational and established treatments in mood disorders respectively. There is a need to better characterize the mechanism of action of these agents. We...

A comparison between psilocybin and esketamine in treatment-resistant depression using number needed to treat (NNT): A systematic review.

Journal of Affective Disorders April 1, 2024 Sabrina Wong, Angela T H Kwan, Kayla M Teopiz et al. 19 citations

Inadequate outcomes with monoamine-based treatments in depressive disorders are common and provide the impetus for mechanistically-novel treatments. Esketamine is a proven treatment recently approved for adults with Treatment-Resistant Depression (TRD) while psilocybin is an investigational treatment. Translation of the clinical meaningfulness for these foregoing agents in adults with TRD is...

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,...