OBJECTIVES: To contextualize the real-world findings of repeated intravenous ketamine infusions for treatment-resistant bipolar depression (TRBPD) and identify priorities for safer, more durable clinical implementation. METHODS: We provide a focused commentary on Zhou et al. (2023) and integrate selected evidence concerning inflammatory and metabolic correlates, neurocognitive outcomes, and...
Treatment-resistant depression (TRD) remains a challenge, necessitating novel interventions that address associated cognitive deficits. The glutamatergic modulator ketamine exerts rapid antidepressant effects, prompting investigators to assess its impact on cognitive function, specifically working memory. This study explored ketamine's influence on working memory and magnetoencephalography...
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...
BACKGROUND: Bipolar depression is the major cause of morbidity in patients with bipolar disorder. It affects psychosocial functioning and markedly impairs occupational productivity. Anhedonia is one of the most debilitating symptoms of depression contributing to treatment resistance. It correlates with suicidality, low quality of life, social withdrawal, and poor treatment response. Currently,...
Renato de Filippis received travel grants and/or speaker/consultant fees from Janssen-Cilag. Pasquale De Fazio declares that the research was conducted without any commercial or financial relationship that could be construed as a potential conflict of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request. Data S1. Please...
The authors have declared no conflict of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
Bipolar DisordersMay 1, 2023William S H Kim, Mikaela K Dimick, Danielle Omrin et al.
There remain few efficacious treatments for bipolar depression, which dominates the course of bipolar disorder (BD). Despite multiple studies reporting associations between depression and cerebral blood flow (CBF), little is known regarding CBF as a treatment target, or predictor and/or indicator of treatment response, in BD. Nitrous oxide, an anesthetic gas with vasoactive and putative...
Nightmares are a very common experience in the general population, with approximately 35%– 45% of individuals experiencing at least one nightmare per month.1 Nightmare disorder, which is characterized by repeated nightmares causing significant distress or impairment, is less frequent but still common, affecting 2%– 8% of the general population.1 Nightmare disorders are highly comorbid with...
Ketamine is a novel drug used for treatment- resistant depression. The initial randomized controlled trials (RCTs) established intravenous (IV) ketamine's rapid antidepressant effects for refrac-tory major depression, leading to its widespread use. However, the data for ketamine's efficacy in treatment- resistant bipolar depression (TRBD) remain minimal. There are 3 single infusion RCTs ( n =...
BACKGROUND: Bipolar depression accounts for most of the disease duration in type I and type II bipolar disorder (BD), with few treatment options, often poorly tolerated. Many individuals do not respond to first-line therapeutic options, resulting in treatment-resistant bipolar depression (B-TRD). Esketamine, the S-enantiomer of ketamine, has recently been approved for treatment-resistant...
Abstract Background Clinical trials have demonstrated rapid antidepressant effects with intravenous (IV) ketamine for major depressive disorder, with relatively less research specifically for bipolar depression. Herein, we describe the real‐world effectiveness of repeated ketamine infusions for treatment‐resistant bipolar depression. Methods This study was conducted in a community clinic in...
NT is a 21-year-old female identifying woman who came to the office of her outpatient psychiatric provider a month after a hospitalization for a brief psychotic episode, later diagnosed as mania, that she believes was triggered by consuming a substantial amount of psilocybe cubensis mushrooms that she had taken recreationally. While she has a positive family history (father and paternal...
Abstract Objective To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment‐resistant major depressive disorder (MDD) or bipolar disorder (BD). Method Adults (N = 201) with treatment‐resistant MDD or BD received repeat‐dose IV ketamine treatment at a community‐based clinic. Mixed features were measured using...
The aim of the current study was to inform ongoing attempts to identify clinically meaningful subcategories of auditory verbal hallucination (AVH), and to evaluate evidence that might pertain to the suitability of current psychological interventions for people with bipolar disorder (BD) who experience psychotic symptoms. A comprehensive synthesis of findings on the phenomenology of AVH and...
To evaluate feasibility and effects of a sub-anesthetic infusion dose of ketamine versus midazolam on suicidal ideation in bipolar depression. Neurocognitive, blood and saliva biomarkers were explored. Sixteen participants with bipolar depression and a Scale for Suicidal Ideation (SSI) score of ≥4 were randomized to ketamine (0.5 mg/kg) or midazolam (0.02 mg/kg). Current pharmacotherapy was...
OBJECTIVE: Patents with anxious bipolar disorder have worse clinical outcomes and are harder to treat with traditional medication regimens compared to those with non-anxious bipolar disorder. Ketamine has been shown to rapidly and robustly decrease symptoms of depression in depressed patients with bipolar disorder. We sought to determine whether baseline anxiety status reduced ketamine's...
OBJECTIVES: Ketamine, an N-methyl d-aspartate (NMDA) antagonist, has rapid antidepressant effects in depressed subjects with bipolar disorder (BD). Evidence supports a role for the glutamatergic system in the pathophysiology of BD. This double-blind, randomized, cross-over study sought to determine cerebral metabolic correlates of antidepressant response to ketamine. METHODS: Twenty-one...
Luckenbaugh DA, Ibrahim L, Brutsche N, Franco‐Chaves J, Mathews D, Marquardt CA, Cassarly C, Zarate CA Jr. Family history of alcohol dependence and antidepressant response to an N ‐methyl‐ d ‐aspartate antagonist in bipolar depression. Bipolar Disord 2012: 14: 880–887. Published 2012. This article is a U.S. Government work and is in the public domain in the USA. Objectives: Both ketamine and...