The pharmacogenomics journal
April 24, 2026
Daniël T Coerts, Sanne Y Smith-Apeldoorn, Jérôme C Oude Nijhuis et al.
Oral esketamine displays therapeutic potential for treatment-resistant depression. However, treatment is complicated by a low and variable bioavailability. Genetic polymorphisms in the cytochrome P450 (CYP) enzymes responsible for esketamine's metabolism may influence bioavailability. In a subsample of patients included in a placebo-controlled trial investigating repeated, low dose oral...
Journal of Psychopharmacology
April 24, 2026
Marco Colizzi, Elisa Morandin, Veronica Croccia et al.
Interleukin-6 (IL-6) has been implicated as a potential predictor of ketamine response in treatment-resistant depression (TRD). Esketamine, the S-enantiomer of ketamine, produces rapid antidepressant effects and offers improved safety and intranasal administration. To examine whether baseline IL-6 predicts treatment response to esketamine in individuals with TRD. Fourteen adults with TRD...
Frontiers in Neurology
April 23, 2026
Jing Cao, ZiYuan Wang, GeGe Lv et al.
Background Paclitaxel (PTX), a broad-spectrum anti-tumor drug, is extensively employed as a first-line chemotherapy for solid tumors, including lung and breast cancers. However, it induces chemotherapy-related pain and anxiety in over 53% of patients. S-ketamine, the S-enantiomer of ketamine, exerts rapid antidepressant effects. In this study, we established a PTX model to examine the effects...
April 21, 2026
Samuel T. Wilkinson
Reserveer ketamine of esketamine voor patiënten bij wie twee tot vier adequate antidepressieve behandelingen onvoldoende effect hebben gehad. Weeg ook de ernst mee; bij milde gevallen is dit doorgaans niet geïndiceerd. Overweeg esketamine bij acute suïcidaliteit bij therapieresistente depressie, ondanks de negatieve studieresultaten. De placebogroepen ontvingen uitstekende intramurale...
April 21, 2026
Samuel T. Wilkinson
Wanneer een patiënt terugvalt na het afbouwen van ketamine of esketamine, overweeg dan een herstart van een inductiekuur (tweemaal per week gedurende enkele weken, vervolgens geleidelijk spreiden). Bij ketamine of esketamine treden dysfore reacties op bij ongeveer 1 op de 200-300 behandelingen. Veel hiervan verdwijnen met ondersteunende zorg alleen; andere vereisen een kortwerkend...
April 21, 2026
Samuel T. Wilkinson
Na het voltooien van deze activiteit dienen deelnemers in staat te zijn om: Geschikte kandidaten voor ketamine of esketamine te identificeren op basis van eerdere behandelmislukkingen, ernst van de aandoening, middelengebruiksgeschiedenis en relevante contra-indicaties. Strategieën te beschrijven voor onderhoudsdosering, afbouw en het omgaan met snelle terugval na het staken van ketamine of...
April 21, 2026
Samuel T. Wilkinson
Reserve ketamine or esketamine for patients who have failed two to four adequate antidepressant trials. Weigh severity too; mild cases may not warrant it. Consider esketamine for acute suicidality in TRD despite the negative trial results. Placebo groups received excellent inpatient standard of care and improved substantially, masking the drug's benefit. Avoid ketamine and esketamine in active...
April 21, 2026
Samuel T. Wilkinson
After completing this activity, participants should be able to: Identify appropriate candidates for ketamine or esketamine based on prior treatment failures, severity, substance use history, and relevant contraindications. Describe strategies for maintenance dosing, tapering, and managing rapid relapse after discontinuation of ketamine or esketamine. Apply clinic-based approaches to managing...
April 21, 2026
Samuel T. Wilkinson
When a patient relapses after tapering off ketamine or esketamine, consider restarting an index course (twice weekly for a few weeks, then spread out). With ketamine or esketamine, dysphoric reactions occur in roughly 1 in 200-300 treatments. Many resolve with supportive care alone; others require a short-acting benzodiazepine such as lorazepam. For esketamine sessions, have patients fast for...
Scientific Reports
April 21, 2026
Rong Ding, Daojie Wang, Guoxin Wang et al.
Elderly colorectal cancer (CRC) patients face high risks of postoperative depression state, inadequately addressed by opioid-based analgesia. Esketamine, an NMDA receptor antagonist with rapid antidepressant effects, offers potential benefits but lacks evidence in this population. This double-blind RCT enrolled 99 elderly (≥ 65 years) CRC resection patients, randomized to three postoperative...