The World Journal of Biological Psychiatry
September 6, 2026
Balwinder Singh, Siamak MahmoudianDehkordi, Jennifer L. Vande Voort et al.
OBJECTIVE: Ketamine is a rapid-acting antidepressant with an incompletely understood mechanism of action. Pharmacometabolomics can identify pathways underlying its effects and response variability. Using data from the Bio-K trial (NCT03156504), a multisite open-label study, we characterised metabolomic signatures of intravenous (IV) racemic ketamine in adults with treatment-resistant depression...
Ther Adv Psychopharmacol
May 22, 2026
Liliana Patarroyo-Rodriguez, Vanessa K. Pazdernik, Jennifer L. Vande Voort et al.
Early suicidal ideation change and suicidality-associated emergency department utilization after ketamine or esketamine treatment in treatment-resistant depression.
CNS Drugs
February 1, 2026
Matheus G Marques, Liliana Patarroyo-Rodriguez, Balwinder Singh
Bipolar disorder affects approximately 40 million individuals worldwide, with depression being the most prominent phase of the illness. Owing to limited treatment options, bipolar depression remains a major public health concern, often causing significant functional impairment and increased suicide risk. Current therapies frequently lack rapid effectiveness, highlighting the need for novel...
The Journal of Clinical Psychiatry
January 21, 2026
Matheus G Marques, Aysegul Özerdem, Simon Kung et al.
1 citation
Objective: Treatment-resistant depression (TRD) affects one-third of patients with major depressive disorder, leading to increased morbidity, health care costs, and suicide risk. TRD lacks a standardized definition, complicating treatment selection. Current guidelines often group treatments broadly without clear prioritization, and evidence gaps persist, particularly regarding newer...
The Journal of Clinical Psychiatry
September 17, 2025
Liliana Patarroyo-Rodriguez, Vanessa K. Pazdernik, Jennifer L. Vande Voort et al.
1 citation
Conclusions: Ketamine and esketamine reduced long-term ED visits for suicidality in individuals with TRD. Further longer-term follow-up research is encouraged to ascertain if these benefits on suicidality reduction are mood state dependent or reflect an independent mechanism.
Journal of Affective Disorders
September 15, 2025
Brandan K Penaluna, Jennifer L. Vande Voort, William V Bobo et al.
4 citations
Previous work has identified four correlated factors (depression phenotypes) using the Montgomery-Åsberg Depression Rating Scale (MADRS)- Sadness, Negative Thoughts, detachment/Interest and Activity (IA), and Neurovegetative. We explored treatment responses to ketamine based on these 4 phenotypes in treatment resistant depression (TRD). This is a secondary analysis of data from an open-label...
Journal of Affective Disorders
August 15, 2025
Stefanie Cavalcanti, Vanessa K Pazdernik, Jennifer L. Vande Voort et al.
3 citations
Chronic stress is a risk factor for depression and may contribute to treatment resistance. This historical cohort study examined the association between baseline perceived stress, measured with the Perceived Stress Scale (PSS), and response to (es) ketamine in treatment-resistant depression (TRD). Adult TRD patients who received intravenous racemic ketamine or intranasal esketamine were...
Journal of Clinical Psychiatry
July 30, 2025
Balwinder Singh, Vanessa K. Pazdernik, Simon Kung et al.
Objective: This study examines the durability (defined as time between treatments) of intravenous ketamine (IV-KET) and intranasal esketamine (IN-ESKET) for treatment-resistant depression (TRD), in a real-world clinical setting with repeated ketamine/esketamine maintenance therapy. Methods: This was a single-center, observational study of adults with TRD who completed acute-phase treatment...
Lancet (London, England)
July 22, 2025
Balwinder Singh, Holly A Swartz, Alfredo B Cuellar-Barboza et al.
66 citations
The hallmark of bipolar disorder is hypomania or mania, and the predominant phase of illness is depression. Affecting approximately 40 million individuals worldwide, bipolar disorder is associated with a substantial psychosocial, medical, and financial burden and increased mortality from suicide and other causes. Diagnosis can be challenging due to symptom overlap with attention-deficit...
Biological Psychiatry Global Open Science
July 1, 2025
Stephen A Murata, Zachary B Madaj, Colt D Capan et al.
1 citation
Treatment-resistant depression (TRD) remains a challenge, but intravenous racemic ketamine offers rapid antidepressant effects. Reliable biomarkers are needed. In this study, we examined kynurenine pathway metabolites and inflammatory cytokines as predictors of ketamine response. The Bio-K study was a multicenter, open-label trial of 74 patients with TRD who received 3 ketamine infusions over...
CNS Drugs
April 1, 2025
Balwinder Singh
6 citations
Trauma is prevalent, with lifetime estimates of traumatic exposure ranging from 70% for a single event to 31% for multiple events. While many recover, a subset develop post-traumatic stress disorder (PTSD), a debilitating condition characterized by distressing memories, avoidance behaviors, hyperarousal, and mood disturbances. The National Comorbidity Survey reports a lifetime PTSD prevalence...
Therapeutic Advances in Psychopharmacology
2025
Ahmed Elmosalamy, Idil Tarikogullari, Liliana Patarroyo-Rodriguez et al.
7 citations
Depression affects approximately 5.7% of adults worldwide, and around one-third of these individuals develop treatment-resistant depression (TRD). Intravenous (IV) ketamine and esketamine (administered IV or intranasally (IN)) are novel treatment options for TRD; however, only IN esketamine currently holds FDA approval. Compare the acute effectiveness of IV ketamine with esketamine (IV or IN)...
The Journal of Clinical Psychiatry
August 25, 2024
Mark A Frye, Balwinder Singh, Scott Breitinger et al.
2 citations
A man with AUD achieves sobriety on treatment with an SSRI and naltrexone, but then stops taking the SSRI to participate in a psilocybin “ceremony.” What factors contributed to his subsequent relapse to alcohol use?
CNS Drugs
August 1, 2024
Liliana Patarroyo-Rodriguez, Stefanie Cavalcanti, Jennifer L. Vande Voort et al.
13 citations
Anhedonia, a complex symptom rooted in deficits across reward processes, is primarily linked to depression and schizophrenia but transcends diagnostic boundaries across various mental disorders. Its presence correlates with poorer clinical outcomes, including an increased risk of suicide and diminished response to treatment. The neurobiological underpinnings of anhedonia remain incompletely...
Journal of Affective Disorders
July 1, 2024
Ashok Seshadri, Larry J. Prokop, Balwinder Singh
50 citations
Intravenous (IV) racemic ketamine and intranasal (IN) esketamine have demonstrated rapid antidepressant effects in treatment-resistant depression (TRD). This systematic review aims to evaluate the efficacy and safety of ketamine and esketamine at various dosages for depression. We included randomized controlled trials (RCTs) with parallel group dose comparison of ketamine and esketamine for...
Bipolar Disorders
June 1, 2024
Rakesh Kumar, Nicolas A. Nunez, Neha Joshi et al.
AbstractBackgroundKetamine is increasingly used for treatment‐resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs).MethodsA comprehensive search of several databases (Ovid MEDLINE®, Embase, and...
Psychiatry Research
May 1, 2024
Balwinder Singh, Sagar V Parikh, Jennifer L. Vande Voort et al.
18 citations
This nonrandomized, multicenter, open-label clinical trial explored the impact of intravenous (IV) ketamine on cognitive function in adults (n = 74) with treatment-resistant depression (TRD). Patients received three IV ketamine infusions during the acute phase and, if remitted, four additional infusions in the continuation phase (Mayo site). Cognitive assessments using the Repeatable Battery...
Journal of Affective Disorders
2024
Liliana Patarroyo-Rodriguez, Vanessa M. Pazdernik, Jennifer L. Vande Voort et al.
12 citations
BACKGROUND Sleep disturbances are highly prevalent in depressive episodes and are linked to higher mood severity and suicidal behaviors. Slow wave sleep (SWS) and REM sleep are compromised in depression. Current evidence suggests that rapid antidepressant effects of intravenous (IV) ketamine in patients with treatment-resistant depression (TRD) is mediated by its effects on SWS and REM sleep....
Brain Sciences
December 22, 2023
Nicolas A. Nunez, Boney Joseph, Rakesh Kumar et al.
20 citations
Ketamine has shown rapid antidepressant and anti-suicidal effects in treatment-resistant depression (TRD) with single and serial intravenous (IV) infusions, but the effectiveness for depressive episodes of bipolar disorder is less clear. We conducted an updated systematic review and meta-analysis to appraise the current evidence on the efficacy and tolerability of ketamine/esketamine in bipolar...
Pharmaceuticals
August 1, 2023
Boney Joseph, Nicolas A. Nunez, Simon Kung et al.
14 citations
Intravenous (IV) ketamine and FDA-approved intranasal (IN) esketamine are increasingly used for treatment-resistant depression (TRD). Preliminary studies have suggested a synergistic effect of ketamine and lamotrigine, although the data are inconclusive. Herein, we report the response to serial ketamine/esketamine treatment among patients with TRD with or without lamotrigine therapy. In this...
Journal of Clinical Psychiatry
February 1, 2023
Balwinder Singh, Simon Kung, Vanessa K. Pazdernik et al.
64 citations
Objective: Ketamine has been redeveloped as a rapid-acting antidepressant for treatment-resistant depression (TRD). There is a paucity of literature comparing subanesthetic intravenous (IV) ketamine and US Food and Drug Administration (FDA)-approved intranasal (IN) esketamine for TRD in real-world clinical settings. We compared the efficacy and time to achieve remission/response with repeated...
Journal of Psychiatric Practice
November 1, 2015
Ajay K Parsaik, Balwinder Singh, Darrow Khosh-Chashm et al.
42 citations
Retracted
To consolidate the evidence from the literature to evaluate the role of ketamine in the treatment of bipolar depression. Major databases, including MEDLINE, EMBASE, Cochrane, and Scopus, were searched through October 2014, for studies reporting the role of ketamine in the treatment of bipolar depression. Only randomized controlled trials were included in the meta-analysis. We calculated...