Objective: To critically review the empirical literature on oral ketamine dosing strategies and administration procedures; and provide pragmatic clinical considerations for its use in out-patient psychiatric settings for treatment-resistant depression and suicidality.Methods: A structured search of PubMed and Google Scholar was conducted to identify peer-reviewed studies published till April...
Objective: Mindfulness is an effective non-pharmacological intervention for mental health.However, little is known about the underlying neurological mechanisms involved, especially glutamate, -aminobutyric acid (GABA), and the excitation-inhibition (E-I) balance.This study examined changes in these markers after mindfulness training and whether these changes are related to the baseline...
The research domain criteria (RDoC) was launched by the National Institute of Mental Health (NIMH) to provide a framework towards development of neurobiological models and novel treatment methods for mental health disorders. Here we elucidate the possible parallels between the RDoC and the understanding of human mind by the early Buddhism, conceptualized as the five aggregates (skandha-s). They...
Major depressive disorder remains a leading cause of global disability, and many patients show limited response to conventional antidepressants.Increasing evidence suggests that a substantial subgroup exhibits chronic low-grade inflammation, which may constrain synaptic plasticity and contribute to persistent depressive symptoms.In this review, we propose that depression can be conceptualized...
The introduction of ketamine and its S-enantiomer, esketamine, has been one of the most consequential advances in treatment-resistant depression (TRD) in recent decades, demonstrating that rapid and clinically meaningful antidepressant effects can occur within hours, even in patients who have not responded to conventional treatments.However, this advance has not resolved the clinical problem of...
To determine whether antibiotic-induced microbiome depletion influences baseline or 3,4-methylenedioxymethamphetamine (MDMA)-induced oxytocin signaling in rats. Male Wistar rats received broad-spectrum antibiotics (ABX) or water for 7 days, followed by a single oral administration of MDMA (30 mg/kg). Plasma oxytocin levels were measured by ELISA, and oxytocin-immunoreactivity in the...
3,4-Methylenedioxymethamphetamine (MDMA) is widely used recreationally but also modulates serotonergic signaling in the gut, potentially influencing the microbiota. Because low bone mineral density (BMD) is common in depression and other psychiatric disorders, we tested whether repeated, intermittent MDMA attenuates BMD loss in ovariectomized (OVX) mice. OVX mice received MDMA (10 mg/kg) three...
Depression is increasingly conceptualized as a disorder of impaired synaptic plasticity and excitation-inhibition imbalance within corticolimbic circuits. Two rapid-acting therapeutic classes, NMDA receptor modulators (ketamine, esketamine) and neuroactive-steroid GABA-A positive allosteric modulators (brexanolone, zuranolone), offer complementary approaches to restore circuit function....
Body scan meditation is a popular mindfulness practice in which a person directs their attention toward internal bodily sensations. Although its neural mechanisms have been investigated using functional magnetic resonance imaging, few studies have used functional near-infrared spectroscopy (fNIRS) to directly measure prefrontal networks during body scan meditation. In this study, symptoms of...
Intranasal (IN) esketamine represents a novel add-on treatment for treatment-resistant depression (TRD) with reported favourable effects on insomnia. IN esketamine treatment might similarly reduce the incidence of insomnia as an adverse event (AE). The present meta-analysis therefore investigated whether IN esketamine relative to placebo is associated with a lower incidence of insomnia as an AE...
Ketamine therapy can reduce the risk of suicide and depression in the treatment resistant patient. Adverse effects of ketamine infusion include blurred vision, nausea and vomiting, hepatotoxicity, headache, and cystitis. However, the effect of ketamine infusion on blood glucose remains unclear. This report describes several episodes of hypoglycemia in a 36-year-old man with type 1 diabetes...
For the first time after many decades, many new antidepressants have been approved and many more are under various stages of development and will soon be available in the market. The new drugs present a range of new mechanisms of action with benefits in terms of speed of action, tolerability and range of treatable disorders. Neurosteroids have been recently approved and their rapid benefit may...
Psilocybin is gaining popularity as research shows potential benefits to those with anxiety, depression, and other mental health conditions. Individuals with risk factors for psychosis are typically excluded from such studies, limiting the empiric research of the risks and benefits in vulnerable populations. In the real-world setting, many individuals who seek treatment with psilocybin will...
: Alpha wave of electroencephalography (EEG) is known to be related to behavioral inhibition. Both the alpha wave and default mode network (DMN) are predominantly activated during resting-state. To study the mechanisms of the trait inhibition, this research investigating the relations among alpha wave, DMN and behavioral inhibition in resting-state. : We explored the relationship among...
Previous studies suggested effectiveness of psilocybin in the field of mental health. FDA designated psilocybin as a "breakthrough therapy" for the treatment of treatment-resistant depression (TRD) in 2018. This paper provided a review of psilocybin's potential role in treatment of depression by focusing on published clinical trials. Studies showed that psilocybin, an agonist on 5-HT2A...
Psilocybin is a classical psychedelic which has been utilised for healing purposes for millenia. However, with its classification as a Schedule I substance, research into this compound is scarce with few FDA-approved clinical studies. Despite this, profound findings into its antidepressant effects (largely through its action on 5-HT1a receptors) in mental illnesses such as major depressive...
Objective: : Treatment Resistant Depression (TRD) is commonly defined as the lack of response to two or more anti-depressants with different mechanisms of action. Up to 30% of patients diagnosed with major depressive disorder might be considered to present TRD. The objective of this study was to assess the effectiveness and tolerability of esketamine in patients diagnosed with TRD, who were...
Depression is a significant cause of morbidity and mortality globally. Although various pharmacologic options exist for depression, treatments are limited by delayed or incomplete therapeutic response, low rates of remission, and adverse effects necessitating effective, fast-acting, and better tolerated alternatives. The purpose of this review is to describe the safety and efficacy of...
The monoamine hypothesis has significantly improved our understanding of mood disorders and their treatment by linking monoaminergic abnormalities to the pathophysiology of mood disorders. Even 50 years after the monoamine hypothesis was established, some patients do not respond to treatments for depression, including selective serotonin reuptake drugs. Accumulating evidence shows that patients...
To evaluate the long-term safety and efficacy of intranasal esketamine in patients with treatment-resistant depression from the Asian subgroup of the SUSTAIN-2 study. SUSTAIN-2 was a phase 3, open-label, single-arm, multicenter study comprising a 4-week screening, 4-week induction, 48-week optimization/maintenance, and 4-week follow-up (upon esketamine discontinuation) phase. Patients with...
OBJECTIVE: Transcranial direct current stimulation (tDCS) and mindfulness practices have been proposed as a potential approach to improve executive functions (EFs) and reduce craving in persons with substance use disorders. Based on the neural mechanisms of action of each of these interventions, the combination of both non-pharmacological interventions might have additive effects. In the...
Objective In this study, we evaluated the effect of neonatal ketamine exposure on anxiety-like and exploratory behaviours in adult the Balb/c and C57BL/6 strains of mice which anxiety responses are different. Methods Ketamine was administered at two different doses single dose (10, 20 mg/kg, 0.1 ml/10 g body weight, intraperitoneally) and repeated doses (10, 20 mg/kg every 240 minutes; thrice...
Objective: Meditation can elicit trait-like changes in psychological and social styles, as well as enhancement of emotional regulatory capacity. We investigated the relation between personality traits and emotional intelligence in meditation practitioners. Methods: Seventy-two long-term practitioners of mind-body training (MBT) and 62 healthy comparative individuals participated in the study....
From neurophenomenological perspectives, schizophrenia has been conceptualized as "a disorder with heterogeneous manifestations that can be integrally understood to involve fundamental perturbations in consciousness". While these theoretical constructs based on consciousness facilitate understanding the 'gestalt' of schizophrenia, systematic research to unravel translational implications of...