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Comments to pharmacological and behavioral divergence of ketamine enantiomers by Jordi Bonaventura et al.

Guang Chen, G. Mannens, Marlies de Boeck, E. Daly, Carla M. Canuso, G. Teuns, Husseini Manji, Wayne C. Drevets

Molecular Psychiatry February 17, 2022 DOI: 10.1038/s41380-022-01447-4 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Open-label study Peer reviewed
Population Patients with treatment-resistant depression
Intervention (R)-ketamine
Topics Esketamine Ketamine
Citations 14
Key points The antidepressant efficacy of (R)-ketamine remains unestablished, and it can cause dissociation similar to (S)-ketamine at equipotent doses.

Abstract

antidepressant ef fi cacy without dissociative effects ” . Open-label study results cannot be used to establish ef fi cacy, partly because they increase the expectancy biases of both the rater and the patient, and even patients with treatment-resistant depression have shown large placebo effect sizes in trials involving various treatment modalities [17]. Thus, as indicated by Bonaventura et al., the antidepressant ef fi cacy and optimal dose of (R)-ketamine will need to be established in RCTs. Regarding dissociation, one of these patients manifested clinically meaningful dissociation, as indicated by a Clinician-Administered Dissociative States Scale score of 5. As a study in healthy volunteers that (R)-ketamine and (S)-ketamine dissociative and other CNS adverse effects that were similar in frequency, and character when compared at doses selected to be equipotent for NMDAR antagonism

Comparable studies

Other non-randomized and open-label trials on ketamine, most cited first.

Study Year Design Participants
Rapid Resolution of Suicidal Ideation After a Single Infusion of anN-Methyl-D-Aspartate Antagonist in Patients With Treatment-Resistant Major Depressive Disorder Subjects with DSM-IV-diagnosed treatment-resistant major depressive disorder 2010 Open-label trial n = 33
Intravenous arketamine for treatment-resistant depression: open-label pilot study Humans with treatment-resistant depression 2020 Open-label pilot trial n = 7
A Phase 2 Open Label Study of Efficacy, Safety, and Tolerability of SLS-002 (Intranasal Racemic Ketamine) in Adults with MDD at Imminent Risk of Suicide. Hospitalized patients with Major Depressive Disorder and acute suicidal ideation and... 2024 Open label study n = 17
Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients 1997 Controlled clinical trial n = 211
Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression Participants with DSM-IV-defined major depressive disorder and treatment-resistant... 2014 Pooled analysis of three clinical trials n = 97

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Esketamine Ketamine Depression