A significant proportion of patients with major depressive disorder are refractory to approved interventions. The first report of significant and rapid benefit of intravenous (IV) ketamine for treatment resistant depression (TRD) appeared in 2000. Since then, there have been multiple reports on the efficacy and tolerability of ketamine formulations for TRD, in particular for single-dose IV...
Substance abuse disorder continues to have devastating consequences for individuals and society and current therapies are not sufficient to provide the magnitude of medical impact required. Although some evidence suggests the use of ketamine in treating various substance use related- symptoms, its adverse event profile including dissociation, dysphoria, and abuse liability limit its potential...
Psilocybin shows efficacy to alleviate depression in human clinical trials for six or more months after only one or two treatments. Another hallucinogenic drug, esketamine, has recently been U.S. Food and Drug Administration (FDA)-approved as a rapid-acting antidepressant. The mechanistic basis for the antidepressant effects of psilocybin and ketamine appear to be conserved. The efficacy of...
OBJECTIVE: Ketamine may reduce suicidal ideation in treatment-resistant depression. But it is not known how quickly this occurs and how long it persists. We undertook a systematic review and meta-analysis to determine the short- and long-term effectiveness of ketamine for suicidality. METHOD: CENTRAL, EMBASE, Medline, and PsycINFO were searched until 12 December 2018. Randomised controlled...
Although currently available antidepressants increase monoamine levels soon after the start of treatment, therapeutic benefits are often delayed by several weeks and the majority of patients with major depressive disorder fail to achieve an adequate response to first- or second-line therapies targeting monoamines. The recent approval of the NMDA (N-methyl-d-aspartate) antagonist esketamine...
In resting-state functional connectivity experiments, a steady state (of consciousness) is commonly supposed. However, recent research has shown that the resting state is a rather dynamic than a steady state. In particular, changes of vigilance appear to play a prominent role. Accordingly, it is critical to assess the state of vigilance when conducting pharmacodynamic studies with resting-state...
BACKGROUND: Only one-third of patients with major depressive disorder achieve remission. One new and promising treatment, ketamine, may prove challenging to implement because of its abuse potential. Although clinicians' views have been sought, we need patients' views before large scale roll-out is considered. AIMS: To explore patients' and carers' views to inform policy and practical decisions...
Major depressive disorder (MDD) is one of the most disabling psychiatric disorders. Approximately one‐third of the patients with MDD are treatment resistant to the current antidepressants. There is also a significant therapeutic time lag of weeks to months. Furthermore, depression in patients with bipolar disorder (BD) is typically poorly responsive to antidepressants. Therefore, there exists...
This Viewpoint discusses recent evidence documenting benefits of nonpharmacological and drug therapies for major depressive disorder including exercise, Mediterranean diet and structured dietary support, ketamine and esketamine, anti-inflammatory drugs, brexanolone, and psilocybin.
Back to table of contents Previous article Next article Full AccessPsychedelic Medicine: Careful Studies, Regulations Are the AnswerPaul SummergradM.D.Paul SummergradSearch for more papers by this authorM.D.Published Online:30 Apr 2019https://doi.org/10.1176/appi.pn.2019.5a25AbstractPaul Summergrad, M.D., is the Dr. Frances S. Arkin Professor and Chair of the Department of Psychiatry and a...