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Joshua D. Rosenblat

University Health Network, University of Toronto

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

Papers

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Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin.

Med (New York, N.Y.) March 8, 2024 Joshua D. Rosenblat, Shakila Meshkat, Zoe Doyle et al. 97 citations

Psilocybin-assisted psychotherapy (PAP) has been associated with antidepressant effects. Trials to date have typically excluded participants with complex presentations. Our aim was to determine the feasibility of PAP in a complex population, including high levels of treatment resistance in major depressive and bipolar disorder and patients with baseline suicidality and significant comorbidity....

A proof-of concept randomized controlled trial to show that the antidepressant effect of psilocybin does not require a psychedelic experience: study protocol

European Psychiatry November 17, 2023 M. I. Husain, Daniel M. Blumberger, David Castle et al.

Introduction During the last decade there has been a resurgence of interest on the use of psychedelics as novel treatments for mental disorders, including treatment-resistant depression (TRD). Psilocybin, the chemical component of “magic mushrooms”, has been administered with psychotherapy in randomized clinical trials (RCTs) showing large and sustained antidepressant effects. As the use of...

Psilocybin-assisted therapy for depression: A systematic review and meta-analysis.

Psychiatry Research November 1, 2023 Sipan Haikazian, David C J Chen-Li, Danica E. Johnson et al. 121 citations

The aim of this review was to determine the effect of psilocybin on depressive symptoms in patients diagnosed with life-threatening illnesses or major depressive disorder. Systematic searches were conducted to search for randomized clinical trials and open-label trials that evaluated depression symptoms after psilocybin therapy. Data was pooled using a random-effects model. The primary outcome...

Real-World Effectiveness of Repeated Ketamine Infusions for Treatment-Resistant Bipolar Depression.

Focus (American Psychiatric Publishing) October 1, 2023 Farhan Fancy, Nelson B Rodrigues, Joshua D. Di Vincenzo et al. 4 citations

Clinical trials have demonstrated rapid antidepressant effects with intravenous (IV) ketamine for major depressive disorder, with relatively less research specifically for bipolar depression. Herein, we describe the real-world effectiveness of repeated ketamine infusions for treatment-resistant bipolar depression. This study was conducted in a community clinic in Mississauga, Ontario (Canadian...

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,...

Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions

World Psychiatry September 15, 2023 Roger S McIntyre, Mohammad Alsuwaidan, Bernhard T Baune et al. 712 citations

Treatment‐resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision‐making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a...

Beyond Psilocybin: Reviewing the Therapeutic Potential of Other Serotonergic Psychedelics in Mental and Substance Use Disorders

Journal of Psychoactive Drugs August 24, 2023 Stanley Wong, An Yi Yu, Nicholas Fabiano et al. 11 citations

There has been a resurgence of interest in the use of psychedelic therapies for several mental and substance use disorders. Psilocybin, a "classic" serotonergic psychedelic, has emerged as one of the primary compounds of interest in clinical research. While research on psilocybin's potential mental health benefits has grown, data on the safety and efficacy of other serotonergic psychedelics...

Predicting outcome with Intranasal Esketamine treatment: A machine-learning, three-month study in Treatment-Resistant Depression (ESK-LEARNING)

Psychiatry Research July 29, 2023 Mauro Pettorruso, Roberto Guidotti, Giacomo D’andrea et al. 56 citations

Treatment-resistant depression (TRD) represents a severe clinical condition with high social and economic costs. Esketamine Nasal Spray (ESK-NS) has recently been approved for TRD by EMA and FDA, but data about predictors of response are still lacking. Thus, a tool that can predict the individual patients' probability of response to ESK-NS is needed. This study investigates sociodemographic and...

Psilocybin for treatment-resistant depression without psychedelic effects: study protocol for a 4-week, double-blind, proof-of-concept randomised controlled trial

BJPsych Open July 1, 2023 Muhammad Ishrat Husain, Nicole Ledwos, Elise Fellows et al. 41 citations

Background Randomised controlled trials (RCTs) of psilocybin have reported large antidepressant effects in adults with major depressive disorder and treatment-resistant depression (TRD). Given psilocybin's psychedelic effects, all published studies have included psychological support. These effects depend on serotonin 2A (5-HT2A) receptor activation, which can be blocked by 5-HT2A receptor...

Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth

Journal of Psychopharmacology May 16, 2023 Noah Chisamore, Kevork Danayan, Nelson B Rodrigues et al. 13 citations

Background: Ketamine is an emerging treatment for treatment-resistant depression (TRD) associated with rapid and robust improvements in depressive symptoms and suicidality. However, the efficacy and safety of ketamine in transitional age youth (TAY; age 18–25) populations remains understudied. Methods: In this retrospective analysis, TAY patients (n = 52) receiving ketamine for TRD were matched...

Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder.

Psychiatry Research March 5, 2023 Kevork Danayan, Noah Chisamore, Nelson B Rodrigues et al. 36 citations

Borderline personality disorder (BPD) has high rates of comorbidity with mood disorders, including treatment-resistant depression (TRD). Comorbidity of BPD with depression is associated with poorer response to antidepressants. Intravenous ketamine is a novel treatment for TRD that has not been specifically evaluated in patients with comorbid BPD. In this retrospective analysis of data collected...

Serotonergic psychedelics for depression: What do we know about neurobiological mechanisms of action?

Frontiers in Psychiatry February 10, 2023 Muhammad Ishrat Husain, Nicole Ledwos, Elise Fellows et al. 47 citations

Introduction Current treatment options for major depressive disorder (MDD) have limited efficacy and are associated with adverse effects. Recent studies investigating the antidepressant effect of serotonergic psychedelics—also known as classic psychedelics—have promising preliminary results with large effect sizes. In this context, we conducted a review of the putative neurobiological...

Oral ketamine for depression: An updated systematic review

World Journal of Biological Psychiatry January 18, 2023 Shakila Meshkat, Sipan Haikazian, Joshua D. Di Vincenzo et al. 61 citations

Abstract Objectives: Ketamine is a glutamate N-methyl-D-aspartate receptor antagonist that can be used to treat major depressive disorder by single or repeated infusions. However, the accessibility and scalability of oral ketamine make it preferred over intravenous ketamine. In this systematic review, we aim to evaluate the efficacy, tolerability, and safety of oral ketamine, esketamine and...

A Phase II, Open-Label Clinical Trial of Intranasal Ketamine for Depression in Patients with Cancer Receiving Palliative Care (INKeD-PC Study)

Cancers January 7, 2023 Joshua D. Rosenblat, Froukje E. deVries, Zoe Doyle et al. 49 citations

Antidepressants require several weeks for the onset of action, a lag time that may exceed life expectancy in palliative care. Ketamine has demonstrated rapid antidepressant effects, but has been minimally studied in cancer and palliative care populations. Herein, the objective was to determine the feasibility, safety, tolerability and preliminary efficacy of intranasal racemic ketamine for...

Ketamine for bipolar depression: an updated systematic review

Therapeutic Advances in Psychopharmacology 2023 Farhan Fancy, Sipan Haikazian, Danica E. Johnson et al. 23 citations

Background: The therapeutic potential of subanesthetic doses of ketamine appears promising in unipolar depression; however, its effectiveness in treating bipolar depression (BD) remains uncertain. Objective: This systematic review aimed to summarize findings on the use of ketamine for the treatment of BD by assessing its efficacy, safety, and tolerability. Design: Systematic review. Methods: We...

Real‐world effectiveness of repeated ketamine infusions for treatment‐resistant bipolar depression

Bipolar Disorders December 14, 2022 Farhan Fancy, Nelson B Rodrigues, Joshua D. Di Vincenzo et al. 35 citations

Abstract Background Clinical trials have demonstrated rapid antidepressant effects with intravenous (IV) ketamine for major depressive disorder, with relatively less research specifically for bipolar depression. Herein, we describe the real‐world effectiveness of repeated ketamine infusions for treatment‐resistant bipolar depression. Methods This study was conducted in a community clinic in...

The association between stage of treatment-resistant depression and clinical utility of ketamine/esketamine: A systematic review.

Journal of Affective Disorders December 1, 2022 Anastasia Levinta, Shakila Meshkat, Roger S McIntyre et al.

Ketamine has demonstrated rapid and significant antidepressant effects in patients with treatment resistant depression (TRD). Herein, we conducted a systematic review to determine ketamine's efficacy as a function of the stage of treatment resistance (e.g., number of failed treatments) among individuals with TRD. A systematic search of PubMed and Scopus from inception to August 2021 was...

A century of research on psychedelics: A scientometric analysis on trends and knowledge maps of hallucinogens, entactogens, entheogens and dissociative drugs.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology November 1, 2022 Marco Solmi, Chaomei Chen, Charles Dauré et al. 55 citations

A scientometric analysis was realized to outline clinical research on psychedelics over the last century. Web of Science Core Collection was searched up to March 18, 2022, for publications on psychedelics. Network analyses and bibliometrics were combined, to identify research themes and trends with Bibliometrix and CiteSpace. The primary aim was to measure research trends evolution over time,...

The therapeutic role of ketamine and esketamine in treating psychopathological domains of depression.

Neuropharmacology November 1, 2022 Muhammad Youshay Jawad, Joshua D. Di Vincenzo, Sebastian Badulescu et al. 29 citations

Over the past two decades, ketamine has emerged as a novel effective and safe rapid-acting antidepressant. While the vast majority of studies on ketamine have focused on its ability to reduce the severity of depression broadly, its effectiveness in specific domains such as cognition, anhedonia, suicidality, and workplace/social/scholastic functionality has been neglected. Similarly, current...

Ketamine as Potential Treatment for Postpartum Depression: A Narrative Review

Annals of Clinical Psychiatry November 1, 2022 David C J Chen-Li, Leanna M.W. Lui, Joshua D. Rosenblat et al. 22 citations

BACKGROUND: Postpartum depression (PPD) is a severe, debilitating mood disorder with consequences for both mothers and children, highlighting the need for rapid-acting and effective treatments for PPD. The aim of this narrative review is to synthesize the available literature on the administration of ketamine for PPD and propose ketamine as a viable and advantageous treatment. METHODS: A search...

Active mechanisms of ketamine-assisted psychotherapy: A systematic review.

Journal of Affective Disorders October 15, 2022 Isak Joneborg, Yena Lee, Joshua D. Di Vincenzo et al.

Few studies have evaluated the efficacy of ketamine-assisted psychotherapy (KAP) in the treatment of treatment-resistant depression (TRD) and substance use disorders (SUD). A systematic review of clinical trials reporting on the efficacy of KAP and discussing mechanisms of action, identified on PubMed and PsycInfo. Five randomized-controlled trials reported on the efficacy of KAP treatment and...

A Research Domain Criteria (RDoC)-Guided Dashboard to Review Psilocybin Target Domains: A Systematic Review.

CNS Drugs October 1, 2022 Niloufar Pouyan, Zahra Halvaei Khankahdani, Farnaz Younesi Sisi et al. 16 citations

Preliminary results from randomized controlled studies as well as identified molecular, cellular, and circuit targets of select psychedelics (e.g., psilocybin) suggest that their effects are transdiagnostic. In this review, we exploit the Research Domain Criteria (RDoC) transdiagnostic framework, to synthesize extant literature on psilocybin. We aimed to identify RDoC-based effects of...

The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder

The Canadian Journal of Psychiatry August 17, 2022 Joshua D. Rosenblat, Muhammad Ishrat Husain, Yena Lee et al. 58 citations

Objective Serotonergic psychedelics are re-emerging as potential novel treatments for several psychiatric disorders including major depressive disorder. The Canadian Network for Mood and Anxiety Treatments (CANMAT) convened a task force to review the evidence and provide a consensus recommendation for the clinical use of psychedelic treatments for major depressive disorder. Methods A systematic...

A review of potential neuropathological changes associated with ketamine

Expert Opinion on Drug Safety May 3, 2022 Danica Nogo, Hana Nazal, Yuetong Song et al. 17 citations

INTRODUCTION: Ketamine is an established intervention for treatment-resistant depression (TRD). However, long-term adverse effects with repeated doses remain insufficiently characterized. Although several animal models have shown N-methyl-D-aspartate glutamate receptor antagonists to produce various neuropathological reactions, attention surrounding the risk of brain lesions has been minimal....

Real-world effectiveness of ketamine in treatment-resistant depression: A systematic review & meta-analysis.

Journal of Psychiatric Research May 1, 2022 Yazen Alnefeesi, David C J Chen-Li, Ella Krane et al. 177 citations

Ketamine is a promising therapeutic option in treatment-resistant depression (TRD). The acute efficacy of ketamine in TRD has been demonstrated in replicated randomised-controlled trials (RCTs), but the generalizability of RCT data to real-world practice is limited. To this end, we conducted a systematic review (Search date: 25/12/2021; 1482 records identified) and meta-analysis of studies...