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Joshua D. Rosenblat

University Health Network, University of Toronto

102 papers in the library · 4,218 citations · publishing 0-2026

Papers

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The effect of ketamine on mitochondrial bioenergetics, viability, and function: A systematic review.

Journal of psychopharmacology (Oxford, England) September 7, 2026 Sabrina Wong, Gia Han Le, Simryn Selby et al.

Extant literature indicates mitochondrial dysfunction may contribute to the pathophysiology of depressive disorders. Preclinical data indicate that anesthetic doses of ketamine are associated with deficits in mitochondrial viability and function. Ketamine and esketamine have demonstrated rapid antidepressant effects in persons with difficult-to-treat depressive disorders. Herein, we aim to...

Serial Ketamine Infusions for Treatment-Resistant Bipolar Depression

JAMA Psychiatry September 2, 2026 Diana K. Orsini, Sara Di Luch, George Tomlinson et al.

Importance Antidepressant efficacy of intravenous (IV) ketamine has been demonstrated in major depressive disorder; however, the efficacy and safety of ketamine for bipolar depression remain largely unknown, with limited data available in this specific population. Objective To evaluate the efficacy, safety, and tolerability of adjunctive IV ketamine compared with midazolam for...

Intranasal Ketamine for Existential Distress in Advanced Cancer.

Journal of Pain and Symptom Management August 1, 2026 Stefan Aguiar, Mary Makarious, Orly Lipsitz et al.

Depression and existential distress are highly prevalent among patients with advanced cancer, and there is growing evidence for ketamine as a rapidly acting antidepressant in the population, but few studies have examined existential distress outcomes with ketamine treatment. The INKeD-PC trial demonstrated efficacy of intranasal racemic ketamine for depression in patients with cancer receiving...

Psychedelics as a potential treatment for borderline personality disorder: A narrative review.

Psychiatry Research July 1, 2026 Erin Artna, Guneet Sandhu, Noah Chisamore et al. 1 citation

Borderline personality disorder (BPD) is a serious mental illness with high rates of morbidity and stigma; however, successful remission is frequently limited by a paucity of accessible treatment options. In an era of growing interest in psychedelics as novel psychiatric treatment modalities, patients with BPD are often excluded from research due to perceived safety risks, particularly...

Changes over time in hallucinogen-related emergency department visits in Ontario, Canada.

Addiction (Abingdon, England) July 1, 2026 Daniel T. Myran, Rachael MacDonald-Spracklin, Alexander R Levesque et al.

Recent increasing interest in hallucinogens has underscored the critical gaps in our understanding of their adverse health effects and healthcare usage over time. The current study aimed to examine changes in emergency department (ED) visit rates involving hallucinogens, clinical outcomes of visits and the characteristics of individuals with ED visits involving hallucinogens. Repeated...

Evaluating the abuse liability of ketamine in the treatment of mood disorders: A systematic review.

Journal of psychopharmacology (Oxford, England) June 24, 2026 Shreya Vasudeva, Gabrielle F. M. Lovell, Sabrina Wong et al.

Ketamine has emerged as a promising rapid-acting treatment for mood disorders and suicidality. Notwithstanding its replicated antidepressant efficacy, ketamine-associated risk for abuse, dependence, and misuse remain. We conducted a systematic review of clinical and preclinical studies from database inception to August 2025, including randomized and observational trials, open-label extensions,...

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...

The Serotonin 2B (5‐ HT2B ) Receptor: A Narrative Review of Preclinical and Clinical Evidence on the Safety Considerations and Therapeutic Potential for the Treatment of Depression

Clinical Pharmacology & Therapeutics May 28, 2026 Gia Han Le, Sabrina Wong, Danica E. Johnson et al.

Major depressive disorder (MDD) and treatment-resistant depression (TRD) remain leading causes of disability, providing the impetus for receptor-level treatment strategies beyond monoamine reuptake. The serotonin 5-HT2B receptor (5-HT2BR) is uniquely positioned at the interface of central-antidepressant mechanisms and peripheral cardiac risks. Herein, we reviewed preclinical, translational and...

Measuring and appraising placebo effects in clinical trials: contemporary challenges and approaches in psychiatry.

The lancet. Psychiatry May 1, 2026 Joseph J Taylor, Balázs Szigeti, Noah D Silverberg et al.

Placebo effects are among the greatest paradoxes in medical research. Although more data on placebos are available from placebo-controlled trials than on any treatment in medicine, there has been comparatively little deep interrogation of issues related to their measurement, appraisal, and interpretation. Most of the work that has been done, including that in psychiatry, is narrowly focused on...

Blinding Integrity in Psychedelic Randomized Clinical Trials

JAMA Psychiatry April 15, 2026 Diana Orsini, Sabrina Wong, Sara Di Luch et al. 4 citations

Importance: Psychedelic drugs possess acute psychoactive effects that can compromise blinding integrity in randomized clinical trials (RCTs). Functional unblinding, when participants or raters correctly identify treatment allocation based on subjective effects, may bias outcomes through expectancy effects, challenging the validity of efficacy estimates and regulatory acceptance. Objective: To...

A systematic review of ketamine and esketamine-induced long-term potentiation and synaptic scaling: Do the molecular and synaptic plasticity effects inform dosing intervals?

Journal of Affective Disorders April 15, 2026 Gia Han Le, Sabrina Wong, Danica E. Johnson et al. 4 citations

Ketamine and esketamine exhibit rapid antidepressant effects in persons with treatment-resistant depression (TRD) and bipolar depression (TRBD). However, the synaptic mechanisms governing dose, frequency, and durability of response remain unclear. This review aims to evaluate the dosing parameters, including minimum dose and optimal dosing intervals, that reliably induce or maintain long-term...

The combination of exercise and psychedelics for the treatment of major depressive disorder

Discover Mental Health March 7, 2026 Nicholas Fabiano, Brendon Stubbs, David W. Lawrence et al.

Upwards of 50% of people do not respond to the primary treatment modalities for major depressive disorder (MDD), which has led to increased attention and use of alternative methods, including exercise and psychedelics. While interventions using either exercise or psychedelics have demonstrated largely positive results in isolation, their synergistic potential has yet to be explored. As such,...

Examining the effects of psilocybin-assisted psychotherapy on anhedonia in treatment-resistant depression

Journal of Affective Disorders February 12, 2026 Erica Kaczmarek, Nelson Rodriguez, Noah Chisamore et al.

Anhedonia, a core symptom of depression, is often resistant to conventional treatments and significantly impacts quality of life. This secondary analysis aimed to evaluate the effects of psilocybin-assisted psychotherapy (PAP) on anhedonia severity in individuals with treatment-resistant depression (TRD). Participants (n = 30) with TRD and a primary diagnosis of Major Depressive Disorder or...

Progress, potential and pitfalls of ketamine as a treatment for depression

Expert Opinion on Pharmacotherapy January 22, 2026 Diana Orsini, Sara Di Luch, Gabrielle F. M. Lovell et al.

Evidence supporting the use of intravenous ketamine and intranasal esketamine for depression has dramatically increased with a large number of clinical trials and real-world effectiveness studies supporting antidepressant effects. Larger studies have provided reassuring data supporting an adequate safety profile, including safety data with long-term treatment. Alternative routes of...

Evaluating the potential risk of ketamine-induced hepatotoxicity in the treatment of mood and anxiety disorders: A systematic review.

General Hospital Psychiatry 2026 Gabrielle F. M. Lovell, Shreya Vasudeva, Diana Orsini et al.

Ketamine is a dissociative anesthetic with potential for treating mood, anxiety, and related disorders; however, concerns have emerged regarding hepatotoxicity in the context of chronic treatment. Systematic searches of PubMed, Scopus, and Ovid databases were conducted from inception to August 2025. Eligible studies included randomized controlled trials (RCTs), observational studies, and case...

Psilocybin in late-life mental health: Addressing depression, loneliness, and existential anxiety

General Hospital Psychiatry December 9, 2025 Gerasimos Konstantinou, Joshua D. Rosenblat, Sarah Hales et al. 4 citations

The global demographic shift toward aging populations has intensified the need for innovative therapeutic interventions targeting late-life mental health conditions, notably depression, loneliness, and existential distress. Traditional pharmacological treatments often exhibit limited efficacy and poor tolerability in older patients, primarily due to age-related physiological changes and the...

Cognitive outcomes following psilocybin-assisted therapy in treatment-resistant depression: A post-hoc analysis of a randomized, waitlist-controlled trial

Progress in Neuro-psychopharmacology and Biological Psychiatry November 22, 2025 Shakila Meshkat, Noah Chisamore, Zoe Doyle et al.

PAP was associated with modest, short-term improvements in performance on measures of processing speed and executive function among individuals with TRD. While these changes appeared independent of mood, they did not consistently exceed expected practice effects. These findings highlight the need for adequately powered, controlled trials to clarify whether observed cognitive changes reflect...

Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis.

Eur Neuropsychopharmacol November 7, 2025 Mikkel Højlund, Helin Y. Kafali, Begüm Kırmızı et al. 12 citations

Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis.

A Systematic Review of the Effects of N-Methyl-D-Aspartate Receptor Antagonists on Pancreatic Islets

Neuroendocrinology October 30, 2025 Sabrina Wong, Gia Han Le, Jens Uhlig et al.

Our results suggest that NMDAR antagonism improves alpha and beta cell function and viability, which may have translational relevance to comorbid metabolic dysfunction in depression. These mechanisms may subserve the antidepressant effects of select NMDA antagonists (e.g., ketamine/esketamine, dextromethorphan). Further research should aim to investigate the effects of subanesthetic doses of...

Biological markers of treatment response to serotonergic psychedelic therapies: a systematic review.

Ther Adv Psychopharmacol October 16, 2025 Stanley Wong, Brett D. M. Jones, Mathura T. Thiyagarajah et al. 3 citations

Background: Results from contemporary clinical trials of serotonergic psychedelic therapies have led to an increasing focus on their potential clinical use across mental disorders. However, studies examining mechanisms of clinical response to psychedelic therapy in psychiatric populations are limited. This review aimed to synthesize evidence from studies examining biomarkers of clinical...

Temporal dynamics in neuroimaging as correlates of therapeutic response to psilocybin in major depressive disorder: A systematic review and critical appraisal

Journal of Affective Disorders September 16, 2025 Sami George Sabbah, Sophie Li, Sabrina Wong et al. 2 citations

Although these findings suggest psilocybin is associated with dynamic and temporally distinct neuroplastic changes linked to clinical improvement, several limitations must be acknowledged. Many studies reused overlapping datasets with high exploratory flexibility and risk of bias. The generalizability of results is therefore constrained. Future research should emphasize independent datasets,...

Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis

Therapeutic Advances in Psychopharmacology September 1, 2025 Stanley Wong, Gray Meckling, Nicholas Fabiano et al. 6 citations

Background: Suicidal ideation, attempts, and deaths present a major and tragic public health concern. Recent trials of psilocybin therapy (PT) have shown promise in treating treatment-resistant depression and have found a reduction in suicidal ideation. Given the growth of PT research, there is a need to further understand its effect on suicidal ideation, attempts, and deaths. Objective: To...

Prospective preference assessment for the Ecstasy for Alleviating Severe Chronic Neuropathic Pain (EASE-Pain) trial.

Canadian journal of anaesthesia = Journal canadien d'anesthesie September 1, 2025 Mindy Lu, Victoria Tucci, Nandana D. Parakh et al.

Emerging evidence suggests that 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy may be a promising intervention for chronic pain. We designed the Ecstasy for Alleviating Severe Chronic Neuropathic Pain (EASE-Pain) trial, a randomized controlled trial comparing MDMA with an active placebo (methylphenidate) for pain relief. We sought to conduct a prospective preference assessment...

Real world effectiveness of maintenance ketamine infusions for treatment-resistant depression in major depressive disorder and bipolar disorder.

Psychiatry Research August 15, 2025 Sipan Haikazian, Roger S McIntyre, Shakila Meshkat et al. 7 citations

Antidepressant effects with sub-anesthetic doses of intravenous ketamine have been previously demonstrated. However, previous studies have primarily evaluated the efficacy of acute treatment protocols, with limited research on maintenance treatment. Moreover, controlled maintenance studies have only included patients with treatment-resistant Major Depressive Disorder (TRD), with no maintenance...

Mapping psilocybin therapy: A systematic review of therapeutic frameworks, adaptations, and standardization across contemporary clinical trials

Journal of Affective Disorders July 18, 2025 Mary E. Kittur, Mingyao Liu, Brett D. M. Jones et al. 12 citations

Accumulating evidence suggests that psilocybin can produce rapid and sustained clinical benefits when administered in conjunction with psychological support. Though non-pharmacological procedures are considered integral, the field lacks therapeutic guidelines and little is known about current practices. This systematic review sought to provide a comprehensive and cross-diagnostic synthesis of...