Lancet Psychiatry
November 1, 2022
S. Smith-Apeldoorn, J. Veraart, J. Spijker et al.
163 citations
Ketamine can quickly reduce depression in people who do not respond to other treatments, but the effect often fades. Maintenance ketamine treatment—repeated doses over time—may help sustain the antidepressant benefit. A review of three randomized trials, eight open-label studies, and 30 case series found that intravenous, intranasal, oral, and possibly intramuscular and subcutaneous maintenance ketamine are effective for sustaining antidepressant effects in treatment-resistant depression. Serious side effects such as tolerance, cognitive problems, addiction, and kidney or urinary issues appear uncommon. Despite limitations in the available studies, maintenance ketamine shows therapeutic potential. More controlled and naturalistic long-term research is needed to clarify its role in routine care.
Journal of Clinical Psychiatry
July 13, 2021
J. Veraart, S. Smith-Apeldoorn, J. Spijker et al.
31 citations
Ketamine is known to have rapid antidepressant effects, but patients with psychotic features are usually excluded from treatment studies due to concerns that ketamine might worsen psychosis. This systematic review examined nine reports (pilot studies and case reports) involving 41 patients with a history of psychosis or current psychotic symptoms who received ketamine for depression or negative symptoms. The findings suggest that short-term ketamine treatment can be both safe and effective in this group, with side effects that were mild and self-limiting. The available evidence does not support the assumption that ketamine exacerbates psychotic symptoms in predisposed patients, although data are limited and further trials are needed.
Journal of Affective Disorders
May 1, 2023
M. Cladder-Micus, J. Vrijsen, A. Fest et al.
For chronically depressed patients who have not responded to prior treatments, mindfulness-based cognitive therapy (MBCT) produces clinical benefits that persist for at least six months after the program ends. Depressive symptoms, quality of life, rumination, mindfulness skills, and self-compassion all remained stable during follow-up, and remission rates actually increased further. Patients who entered treatment with higher levels of rumination showed greater reductions in depressive symptoms and better quality of life at six months, after accounting for initial symptom severity. Other factors—duration of the current depressive episode, degree of treatment resistance, childhood trauma, and baseline mindfulness or self-compassion—did not predict outcomes.
Depression and Anxiety
November 9, 2021
J. D. de Klerk-Sluis, M. Huijbers, S. Löcke et al.
Mindfulness-based cognitive therapy (MBCT) helps prevent relapse in major depressive disorder by reducing cognitive reactivity and rumination while increasing self-compassion and mindfulness. The authors note that while rumination and mindfulness after MBCT are linked to relapse, no prior research has examined whether these factors—along with cognitive reactivity and self-compassion—are associated with relapse before MBCT begins. This gap suggests that pre-treatment psychological characteristics may influence treatment outcomes, but the study does not report any new empirical data.
Depression and Anxiety
August 8, 2018
M. Cladder-Micus, A. Speckens, J. Vrijsen et al.
Mindfulness-based cognitive therapy (MBCT) is effective for patients with remitted or currently active depression, but its effectiveness for those with chronic, treatment-resistant depression has not yet been established.
BMC Psychiatry
November 9, 2015
M. Cladder-Micus, J. Vrijsen, E. Becker et al.
A randomized controlled trial will compare Mindfulness-Based Cognitive Therapy (MBCT) plus treatment-as-usual (TAU) against TAU alone for patients with chronic, treatment-resistant depression who have already received antidepressant medication and either cognitive behavioral therapy or interpersonal therapy. The primary outcome is depressive symptoms; secondary outcomes include remission rates, quality of life, rumination, mindfulness skills, and self-compassion. Assessments occur at baseline and after the intervention or TAU period, with follow-up at three and six months post-MBCT for completers. The trial aims to provide information on MBCT's effectiveness in this population.