Ketamine is a rapid-acting antidepressant with demonstrated efficacy in major depressive disorder and treatment-resistant depression, yet the mechanisms by which its molecular actions translate into sustained clinical improvement remain incompletely understood. Prevailing models have emphasized N-methyl-D-aspartate receptor antagonism and downstream glutamatergic signaling; however, convergent...
BACKGROUND Cannabis-induced psychosis presents complex sex-based disparities that challenge traditional epidemiological patterns. While males demonstrate higher cannabis use rates, emerging evidence reveals paradoxical vulnerability patterns where females may show heightened susceptibility to cannabis-related psychotic outcomes despite lower consumption rates. OBJECTIVE To map evidence for...
Suicidal ideation and deliberate self-harm are frequent and persistent in treatment-resistant depression (TRD), particularly when comorbid borderline personality disorder (BPD) is present. Real-world evidence on antisuicidal outcomes during intranasal esketamine in this population remains limited. In this multicentre prospective observational study, 90 outpatients with TRD received intranasal...
Asian Journal of PsychiatryJune 1, 2026Hariprasad Ganapathy Vijayakumar, Varsha Shamanna, Harsh Pathak et al.1 citation
Treatment resistance in bipolar depression is one of the most challenging clinical conditions to treat in psychiatry. We present a case of an elderly gentleman with chronic Multi-Therapy Resistant Bipolar Depression (MTRBD), where ketamine, a preferential NMDAR blocker on cortical GABAergic interneurons, is used adjunctively with sequential theta burst stimulation (sTBS) to achieve remission....
Asian Journal of PsychiatryMay 16, 2026Sonia Shenoy, Vijetha Shenoy Belle, Ravindra Neelakanthappa Munoli et al.1 citation
Background: Oral ketamine is a novel treatment for management of depression. However, evidence related to its effectiveness and safety is unavailable. This systematic review aimed to assess the short-term efficacy and safety of oral ketamine compared to placebo or other modes of ketamine in randomized controlled trials (RCT) in unipolar depression, bipolar depression, and treatment-resistant...
BACKGROUND Cannabis-induced psychotic disorders represent 12-35% of first-episode psychosis presentations globally. Traditional clinical wisdom holds these conditions carry favorable prognosis based on rapid symptomatic improvement, yet this narrative rests almost exclusively on symptomatic outcomes, overlooking functional, cognitive, and subjective recovery dimensions. OBJECTIVE To...
This paper explores pranayama, the ancient yogic practice of breath control, as a promising natural method of neuromodulation. Pranayama aims to regulate the flow of prana (life force) to enhance mental clarity, emotional balance, and physiological resilience. We synthesize evidence from clinical, neuroimaging, and psychophysiological studies, illustrating how various pranayama techniques -...
Cannabis use represents a significant risk factor for both psychotic disorders and suicidal behaviors, with growing evidence suggesting complex interactions between these variables. This systematic review examines the relationship between cannabis use and suicide risk in first-episode psychosis (FEP) patients, and explores underlying mechanisms, moderating factors, and intervention strategies....
Psychedelics are increasingly used in the general population, yet they are associated with increased risk of psychosis in a minority of users that can experience psychedelic-induced psychosis (<1 % in controlled trial settings). In contrast, the evidence regarding the treatment of psychedelics-induced psychosis remains to date scarce. We conducted a PRISMA 2020-compliant systematic review...
Student mental health is receiving increasing attention due to escalating academic, social, and emotional pressures, particularly in Asian educational contexts. Mindfulness-Based Stress Reduction (MBSR), has shown consistent effectiveness in alleviating anxiety, enhancing emotional regulation, and fostering psychological resilience among students. While the systematic review by Hue et al....
N-methyl-D-aspartate receptors (NMDA receptors) play a crucial role as ionotropic glutamate receptors in regulating neuroplasticity, learning, memory, and a range of psychiatric disorders. Studies indicate that dysfunction of NMDA receptors is a key pathological mechanism in depression, where abnormal activation can result in neuronal excitotoxicity, excessive extracellular calcium ion...
Mindfulness-Based Stress Reduction (MBSR) has shown potential in reducing anxiety-related symptoms. This systematic review examines the effectiveness of MBSR in treating anxiety disorders in individuals aged 13-26. The review addresses three key themes: "The Prevalence and Impact of Anxiety Disorders in Everyday Life," "The Efficacy and Effectiveness of MBSR in the Management of Anxiety...
Eastern spiritual traditions offer insights into the mind-body approaches to enhance health and well-being. These insights focus on self-awareness (the path of knowledge), intrinsically motivated and selfless action (karma yoga) and on faith and compassion (Bhakti yoga). Yogic meditative practices (Dhyana yoga), developed by ancient Hindu and other eastern traditions, are effective tools to...
The Equanimity Scale (ES-16) is a psychometric tool developed to measure an individual's level of equanimity, which refers to a state of psychological stability and composure, especially under stress. Given the importance of cross-cultural research in psychology, translating the ES-16 into different languages is essential. This study aimed to translate the Equanimity Scale-16 into Hindi and...
The simplest, most convenient, and least expensive way to treat depressed and suicidal patients with ketamine is to administer racemic ketamine by the oral route. We describe the first active-controlled randomized clinical trial of oral racemic ketamine for suicidal ideation associated with depression. Adult patients with major depressive disorder and expressed suicidal ideation were randomized...
Ketamine's unique pharmacological profile, safety, modulation of multiple neurotransmitter systems, and ability to produce neuroplastic changes make it a subject of study with implications for a wide range of neuropsychiatric disorders beyond its traditional use as an anesthetic agent. This article aims to provide an overview of the pharmacology of ketamine and briefly discuss its emerging use...
Agitation, a significant psychiatric issue often linked to conditions like schizophrenia, bipolar disorder, and major depression, invariably pose challenges in emergency settings. Acute agitation occurs in 2.6 % of emergency cases and up to 12.2 % among patients with schizophrenia or bipolar disorder. With limited available options for effective management of acute agitation, ketamine is...
Chronic ketamine use leads to cognitive impairments, however, the neural mechanisms underpinning these impairments are still unclear. Many studies showed Anterior cingulate cortex (ACC)is strongly involved in cognition and drug addiction, as supported by our previous studies. The objective of this study was to assess the variations in resting-state functional connectivity (FC) changes in the...
Psychedelic drug therapy has gained prominence for its potential in treating various mental health conditions, including depression, post-traumatic stress disorder (PTSD), and anxiety. Psychedelic treatment differs from conventional psychiatric approaches in mode of action, legal status, and treatment approach. This work delves into the therapeutic potential, mechanisms, and regulatory...
In the contemporary landscape of psychiatric medicine, critical advancements have been noted in the utilization of psychoactive substances such as hallucinogens, 3,4-methylenedioxymethamphetamine (MDMA), and ketamine for the treatment of severe mental health disorders. This review provides a detailed evaluation of these substances, focusing on their mechanisms of action and the profound...
Ketamine can induce persisting psychosis in a subset of individuals who use it chronically and heavily. Previously, we found that the psychopathology and cognitive impairments in patients with ketamine dependence (KD) exhibiting persistent psychosis (KPP) bear resemblances with schizophrenia, albeit with less severity in those with no persistent psychosis (KNP). Furthermore, we also showed that...
For depression, ketamine is more conveniently administered by oral than by intravenous (iv) routes. The relative antidepressant efficacy of oral vs iv ketamine is unknown. To assess the acute efficacy and the persistence of improvement with open-label oral versus iv ketamine in outpatients with treatment-resistant depression (TRD). Adults with TRD were randomized to oral (N=30) or IV (N=31)...
Symptoms that emerge during pharmacological treatment of bipolar depression are frequently observed, underscoring the necessity for comprehensive treatment monitoring. This observational study sought to observe the correlation of eight intravenous ketamine infusions with treatment-emergent depressive symptoms in treatment-resistant bipolar depression patients who maintained their baseline...
In Japan, the landscape of clinical practice for substance use disorder is changing significantly, primarily due to an increase in patients using over-the-counter drugs. A major concern is the rising number of patients misusing dextromethorphan (DXM). These patients with DXM use disorders often have severe trauma-related and mood symptoms, and therefore try to cope with those symptoms by...
Postpartum depression (PPD) is a psychiatric condition affecting women post-childbirth. Medication combined with psychotherapy, is the current protocol for its treatment. A meta-analysis was conducted using RevMan 5.4 to explore the efficacy and safety of peri-partum administration of esketamine for preventing PPD. After searching several databases to retrieve the relevant RCTs, seven were...