Ketamine for Bipolar Depression: Biochemical, Psychotherapeutic, and Psychedelic Approaches
Raquel Bennett, Christian Yavorsky, Gary Bravo
Frontiers in Psychiatry May 23, 2022 DOI: 10.3389/fpsyt.2022.867484 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Anxiety Ketamine Depression Esketamine |
| Keywords | Bipolar disorder Depression economics Antidepressant Psychotherapist Refractory planetary science Clinical psychology Cognition |
| Citations | 12 |
| Key points | Proposes three paradigms for ketamine treatment—biochemical, psychotherapeutic, and psychedelic—with broad applicability beyond bipolar depression. |
Abstract
Bipolar disorder (type 1) is a serious and chronic psychiatric illness that can be difficult to treat. Many bipolar patients have refractory depressive episodes. Racemic ketamine, a glutamate modulator with prominent dissociate and psychedelic properties, has been demonstrated to have rapid acting antidepressant and anti-obsessional effects which may be useful for treating the symptoms of bipolar depression. Most of the existing research literature on unipolar and bipolar depression has looked at racemic ketamine in the sub-psychedelic dose range given by infusion as a stand-alone treatment (without concurrent psychotherapy). This article expands on the existing research by articulating three different paradigms for ketamine treatment: biochemical, psychotherapeutic, and psychedelic. The authors use composite clinical vignettes to illustrate different ways of working with ketamine to treat bipolar depression, and discuss a variety of clinical considerations for using ketamine with this population, including route, dose, frequency, chemical mitigators, and adverse events. Note that the conceptual paradigms could be applied to any ketamine treatment, with broad applicability beyond bipolar treatment.
Comparable studies
Other theoretical and historical papers on ketamine for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Arketamine for cognitive impairment in psychiatric disorders | 2023 | Theoretical or philosophical paper | |
| Potential effect of ketamine in treatment for dextromethorphan use disorder exploding in Japanese young population. | 2024 | Theoretical or philosophical paper |
Citations in the library
Cited by 13
- Reconsidering "dissociation" as a predictor of antidepressant efficacy for esketamine. Psychopharmacology April 1, 2023
- Mapping consent practices for outpatient psychiatric use of ketamine. Journal of Affective Disorders September 1, 2022
- Double-Blind Comparison of the Two Hallucinogens Dextromethorphan and Psilocybin: Experience-Dependent and Enduring Psychological Effects in Healthy Volunteers Psychedelic Medicine August 30, 2023
- Therapeutic Protocols Using Ketamine and Esketamine for Depressive Disorders: A Systematic Review. Journal of Psychoactive Drugs 2024
- Central nervous system-related safety and tolerability of add-on ketamine to standard of care treatment in treatment-resistant psychotic depression in patients with major depressive disorder and bipolar disorder Frontiers in Neuroscience July 11, 2023
and 8 more in the library
Cites 31
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Archives of General Psychiatry March 1, 1994
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psychedelics and the essential importance of context. Journal of Psychopharmacology February 15, 2018
- A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders JAMA Psychiatry March 1, 2017
and 26 more in the library