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Sara Costi

9 papers in the library · 761 citations · publishing 2017-2026

Papers

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Ketamine attenuates habenula activity in response to aversive outcomes during Pavlovian learning

bioRxiv (Cold Spring Harbor Laboratory) February 10, 2026 Erdem Pulcu, Sara Costi, Pilar Artiach-Hortelano et al.

Abstract Ketamine is an NMDA receptor antagonist with rapid-antidepressant properties when administered at a sub-anesthetic dose. Preclinical models indicate that a direct injection of ketamine into lateral habenula (Hb), a small midbrain structure with an evolutionarily preserved role in aversive learning across mammals, can rapidly relieve depression-like behavior. However, there is limited...

The cognitive neuroscience of ketamine in major depression.

Brain : a journal of neurology June 30, 2025 Sara Costi, Chloe Wigg, Erdem Pulcu et al. 3 citations

Ketamine's potential as a rapid-acting antidepressant was first identified in 2000, despite its long-standing use as an anesthetic agent. Clinically, ketamine alleviates depressive symptoms, including the difficult to treat symptom of anhedonia, within hours, with the effects of a single dose lasting for days. Since then, research has focused on uncovering the mechanisms underlying its rapid...

Combining Ketamine Infusions and Written Exposure Therapy for Chronic PTSD: An Open-Label Trial.

The Journal of Clinical Psychiatry April 2, 2025 Adriana Feder, Oneysha Brown, Sarah B. Rutter et al.

Objective: This open-label clinical trial examined the preliminary efficacy of combining a course of 6 ketamine infusions with a brief, evidence-based exposure-based psychotherapy-written exposure therapy (WET)-in patients with chronic posttraumatic stress disorder (PTSD). Methods: The trial was conducted between June 2021 and October 2023. Patients with chronic PTSD and high-moderate to severe...

Ketamine vs Electroconvulsive Therapy for Treatment-Resistant Depression: A Secondary Analysis of a Randomized Clinical Trial.

JAMA Network Open June 3, 2024 Manish Kumar Jha, Samuel T. Wilkinson, Kamini Krishnan et al. 29 citations

The ELEKT-D: Electroconvulsive Therapy (ECT) vs Ketamine in Patients With Treatment Resistant Depression (TRD) (ELEKT-D) trial demonstrated noninferiority of intravenous ketamine vs ECT for nonpsychotic TRD. Clinical features that can guide selection of ketamine vs ECT may inform shared decision-making for patients with TRD. To evaluate whether selected clinical features were associated with...

Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression.

New England Journal of Medicine May 24, 2023 A. Anand, S. Mathew, Gerard Sanacora et al. 263 citations

BACKGROUND Electroconvulsive therapy (ECT) and subanesthetic intravenous ketamine are both currently used for treatment-resistant major depression, but the comparative effectiveness of the two treatments remains uncertain. METHODS We conducted an open-label, randomized, noninferiority trial involving patients referred to ECT clinics for treatment-resistant major depression. Patients with...

Whole blood transcriptional signatures associated with rapid antidepressant response to ketamine in patients with treatment resistant depression

Translational Psychiatry January 10, 2022 F. Cathomas, L. Bevilacqua, Aarthi Ramakrishnan et al. 44 citations

Ketamine has rapid and sustained antidepressant effects in patients with treatment-resistant depression (TRD). However, the underlying mechanisms of action are not well understood. There is increasing evidence that TRD is associated with a pro-inflammatory state and that ketamine may inhibit inflammatory processes. We thus investigated whole blood transcriptional profiles related to TRD and...

Neuroimaging correlates and predictors of response to repeated-dose intravenous ketamine in PTSD: preliminary evidence

medRxiv Preprint Server April 10, 2021 Agnes Norbury, Sarah B. Rutter, Abigail B. Collins et al. 1 citation preprint

Promising initial data indicate that the glutamate N-methyl-D-aspartate (NMDA) receptor antagonist ketamine may be beneficial in post-traumatic stress disorder (PTSD). Here, we explore the neural correlates of ketamine-related changes in PTSD symptoms, using a rich battery of functional imaging data (two emotion-processing tasks and one task-free scan), collected from a subset of participants...

A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder.

American Journal of Psychiatry January 5, 2021 Adriana Feder, Sara Costi, Sarah B. Rutter et al. 239 citations

OBJECTIVE Posttraumatic stress disorder (PTSD) is a chronic and disabling disorder, for which available pharmacotherapies have limited efficacy. The authors' previous proof-of-concept randomized controlled trial of single-dose intravenous ketamine infusion in individuals with PTSD showed significant and rapid PTSD symptom reduction 24 hours postinfusion. The present study is the first...

Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome

Translational Psychiatry March 21, 2017 Drew D. Kiraly, Sarah R. Horn, Nicholas T. van Dam et al. 182 citations

Abstract A subset of patients with depression have elevated levels of inflammatory cytokines, and some studies demonstrate interaction between inflammatory factors and treatment outcome. However, most studies focus on only a narrow subset of factors in a patient sample. In the current study, we analyzed broad immune profiles in blood from patients with treatment-resistant depression (TRD) at...