Pharmaceutics
December 22, 2023
Ludivine Boudieu, Myriam Mennetrier, Pierre-Michel Llorca et al.
22 citations
Ketamine and its enantiomers represent an innovative glutamatergic agent as a treatment for individuals with treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal ideation and behavior. Intranasal (IN) formulations could allow for quick onset of action on depressive symptoms as well as a reduction in side effects by bypassing the blood–brain barrier compared...
Brain Sciences
December 22, 2023
Nicolas A. Nunez, Boney Joseph, Rakesh Kumar et al.
20 citations
Ketamine has shown rapid antidepressant and anti-suicidal effects in treatment-resistant depression (TRD) with single and serial intravenous (IV) infusions, but the effectiveness for depressive episodes of bipolar disorder is less clear. We conducted an updated systematic review and meta-analysis to appraise the current evidence on the efficacy and tolerability of ketamine/esketamine in bipolar...
Frontiers in Psychiatry
December 8, 2023
Alina Wilkowska, Wiesław Jerzy Cubała
10 citations
Bipolar depression constitutes a major problem in psychiatry. It correlates with high suicidality, treatment resistance, chronicity, and poor quality of life. Registered treatment for bipolar depression is limited and insufficient. There is an urgent need for implementing new therapeutic strategies. Intranasal ketamine’s enantiomer—esketamine is a novel rapid-acting antidepressant with proven...
British Journal of Anaesthesia
December 1, 2023
Wenying Duan, Kang Peng, Hui-Min Qin et al.
BACKGROUND Delayed emergence from general anaesthesia poses a significant perioperative safety hazard. Subanaesthetic doses of ketamine not only deepen anaesthesia but also accelerate recovery from isoflurane anaesthesia; however, the mechanisms underlying this phenomenon remain elusive. Esketamine exhibits a more potent receptor affinity and fewer adverse effects than ketamine and exhibits...
Annals of General Psychiatry
November 26, 2023
Giuseppe Maina, Marina Adami, Giuseppe Ascione et al.
56 citations
Abstract Background Treatment-resistant depression (TRD) is defined by the European Medicines Agency as a lack of clinically meaningful improvement after treatment, with at least two different antidepressants. Individual, familiar, and socio-economic burden of TRD is huge. Given the lack of clear guidelines, the large variability of TRD approaches across different countries and the availability...
Frontiers in Psychiatry
November 23, 2023
Florian Buchmayer, Siegfried Kasper
19 citations
Intranasal esketamine for treatment-resistant depression has been introduced and approved by the FDA and EMA in 2019 and 2020, respectively. Since then, the administration practices were found different among countries. Major depression has a high impact on many humans lives worldwide and more than a third of treated people are not responding after several treatment attempts. Additional...
European Psychiatry
November 17, 2023
Émeline Gaudré-Wattinne, Lila Mekaoui, Maud Rothärmel et al.
1 citation
Introduction Esketamine nasal spray has been developed for patients with treatment resistant depression. Objectives A cohort Temporary Authorization for Use (ATUc) allowed to collect for a 6-month period the first data in real life Methods On 02/08/2019 the French National Agency for Medicines and Health Product Safety granted an early access program for Esketamine nasal spray framed by a...
European Psychiatry
November 17, 2023
N. Veluri, Zeeshan Mansuri
1 citation
Introduction Globally, depression affects millions of individuals. A third of depression patients meet the criteria for treatment-resistant depression (TRD). The N-methyl-D-aspartate receptor antagonist, ketamine, improved depressive symptoms in a span of 24-hours. Recently, the FDA approved esketamine, an enantiomer of ketamine for TRD. Objectives To determine the effectiveness of ketamine and...
Australasian Psychiatry
November 14, 2023
Judith D. Hope, David L Copolov, John Tiller et al.
Objective To review the usefulness of esketamine for treatment-resistant depression. Method Pivotal trials of intranasal esketamine in treatment-resistant depression were synthesized as a narrative review. Results Esketamine is postulated to act through antagonism of N-methyl-D-aspartate (NMDA) glutamate receptors, but opioidergic effects may also be involved. Unlike intravenous ketamine,...
Journal of Affective Disorders
November 8, 2023
Itsuki Terao, Takahiro Tsuge, Kaori Endo et al.
32 citations
BACKGROUND Intravenous racemic ketamine is a promising treatment for treatment-resistant depression. However, its clinical utility compared with intranasal esketamine and the other well-studied conventional pharmacological interventions (i.e., aripiprazole and lithium) as augmentative treatments for treatment-resistant unipolar depression in adults remains unclear. Therefore, we aimed to...
Quality of Life Research
November 2023
Carol Jamieson, Carla M. Canuso, Dawn F. Ionescu et al.
To assess the effect of esketamine nasal spray on patient-reported outcomes (PROs) in patients with major depressive disorder having active suicidal ideation with intent (MDSI). Patient-level data from two phase 3 studies (ASPIRE I; ASPIRE II) of esketamine + standard of care (SOC) in patients (aged 18-64 years) with MDSI, were pooled. PROs were evaluated from baseline through end of the...
Frontiers in Psychiatry
October 31, 2023
Albino J Oliveira-Maia, Benoit Rive, Joachim Morrens et al.
6 citations
BackgroundThe efficacy of esketamine nasal spray (NS) as a rapid-acting agent for treatment resistant depression (TRD) was demonstrated in comparisons with placebo, when both were given in addition to a newly initiated selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI). How esketamine NS compares with commonly used real-world (RW) polypharmacy...
Psychiatry Research Case Reports
October 18, 2023
Giacomo D’andrea, Ornella di Marco, Francesco Maria Semeraro et al.
1 citation
Rapid Cyclic Bipolar Disorder (RCBD) is a debilitating condition that manifests as four or more episodes of depression, mania, or hypomania in a span of one year, with depression being the predominant event. RCBD is prevalent among individuals diagnosed with bipolar disorder and is associated with elevated suicide risk, prolonged disease duration, unfavorable clinical outcomes, and cognitive...
New England Journal of Medicine
October 4, 2023
Andreas Reif, Istvan Bitter, Jozefien Buyze et al.
197 citations
BACKGROUND: In treatment-resistant depression, commonly defined as a lack of response to two or more consecutive treatments during the current depressive episode, the percentage of patients with remission is low and the percentage with relapse is high. The efficacy and safety of esketamine nasal spray as compared with extended-release quetiapine augmentation therapy, both in combination with...
FOCUS: The Journal of Lifelong Learning in Psychiatry
October 1, 2023
Farhan Fancy, Nelson B Rodrigues, Joshua D. Di Vincenzo et al.
4 citations
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. This study was conducted in a community clinic in Mississauga, Ontario (Canadian...
Biomedicines
September 28, 2023
Hans O. Kalkman
8 citations
Ketamine is a racemic mixture composed of two enantiomers, S-ketamine and R-ketamine. In preclinical studies, both enantiomers have exhibited antidepressant effects, but these effects are attributed to distinct pharmacological activities. The S-enantiomer acts as an NMDA-channel blocker and as an opioid μ-receptor agonist, whereas the R-enantiomer binds to σ1-receptors and is believed to act as...
BMJ Open
September 25, 2023
Cen Chen, Qingfeng Wei, Jiajia Zhu et al.
7 citations
Introduction Depressive symptoms have surfaced as the principal mental health concern among patients with breast cancer, with surgical interventions potentially exacerbating these symptoms and adversely influencing clinical outcomes. This study protocol is designed to investigate the efficacy of low-dose esketamine administered perioperatively on depressive symptoms in patients with breast...
Journal of Affective Disorders
September 20, 2023
Isaure Estrade, Anne-Cécile Petit, Vincent Sylvestre et al.
Background: The efficacy of esketamine in treatment-resistant depression (TRD) has been confirmed. However, its administration is expensive and restrictive, with limited knowledge on how long the treatment should be continued. Predicting the treatment outcome would benefit patients and alleviate the global treatment cost. We aimed to define distinct trajectories of treatment response and assess...
Biomolecules
September 19, 2023
Karolina Wydra, Kacper Witek, Agata Suder et al.
8 citations
BACKGROUND: Cocaine use disorder (CUD) is a relapsing brain disease caused by a chronic drug intake that involves neural mechanisms and psychological processes, including depression. Preclinical and clinical studies have demonstrated the promise of pharmacological drugs in controlling the reinstatement of cocaine by targeting the N-methyl-D-aspartate (NMDA) receptor. Recent evidence has...
Child and Adolescent Psychiatry and Mental Health
September 14, 2023
Xiaofeng Lan, Chengyu Wang, Fan Zhang et al.
22 citations
BACKGROUND: Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder (MDD) and suicidal ideation. METHOD: In this randomized-controlled trial, 51 participants aged 13-18...