Background: Depression is a multifactorial disorder involving neurotransmitter dysregulation, HPA axis hyperactivity, neuroinflammation, and impaired neuroplasticity. While combination psychotherapy and pharmacotherapy remains first-line, ~30% of patients develop TRD. In the last few years ketamine has emerged as a rapid-acting therapeutic option for treatment-resistant cases. Aim: To review...
Cerca de 30% dos pacientes com transtorno depressivo maior não respondem a nenhum dos antidepressivos. Caracterizando a depressão resistente ao tratamento (DRT). Esta revisão narrativa teve como objetivo analisar criticamente as evidências sobre o uso da cetamina e da escetamina no tratamento da DRT, incluindo eficácia, mecanismos de ação, perfil de segurança e barreiras de acesso. Foram...
Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, was first approved by the US FDA as KETALAR® for induction and maintenance of general anesthesia. Ketamine has been used off-label for depression treatment, while its S-enantiomer, esketamine (SPRAVATO®), is approved for treatment-resistant depression and major depressive disorder with acute suicidal ideation or behavior. High doses...
Introduction The glutamatergic system is implicated in the pathogenesis of Treatment Resistant Depression (TRD), evidenced by the efficacy of ketamine, a N-methyl-D-aspartate receptor (NMDAR) antagonist. This hypothesis suggests that NMDAR inhibition promotes glutamate release via suppression of NMDAR GABAergic interneurons (1). Studies report reduced plasmatic Gamma AminoButiric Acid (pGABA)...
European PsychiatryJune 1, 2026P. Argitis, M. Demetriou, V. Anagnostopoulou et al.
Introduction Acute suicidal ideation after a suicide attempt is a psychiatric emergency requiring immediate treatment. IV ketamine (0.5 mg/kg), with rapid onset, may offer such benefit. This study examines its efficacy and safety as a first-line intervention for swiftly resolving suicidal ideation in patients post-attempt, including in outpatient and consultation-liaison psychiatry settings....
Aims: Treatment-resistant depression (TRD) is common and associated with substantial disability and economic burden. It is estimated to affect over 100 million people worldwide and approximately 2.7 million people in the United Kingdom. Ketamine has emerged as a novel therapy for TRD, with studies demonstrating rapid antidepressant effects. However, ketamine is also used recreationally and can...
Introduction Treatment-Resistant Depression (TRD) is a major clinical challenge, affecting about 30% of patients with major depressive disorder. It is associated with high morbidity and mortality, reflected in increased suicide risk, hospitalizations, and impaired quality of life. Electroconvulsive Therapy (ECT) remains the therapeutic gold standard, particularly in severe cases with psychotic...
Introduction Suicidal crisis represents a major psychiatric emergency, often occurring in the context of mood disorders and requiring rapid, effective interventions. Traditional antidepressant treatments usually have a delayed onset of action, underscoring the need for fast-acting therapeutic alternatives. In recent years, ketamine—an NMDA receptor antagonist—has emerged as a promising option...
Introduction TBI patients often suffer from severe, treatment-resistant depression and PTSD. Ketamine shows promise in non-TBI populations, but its efficacy in TBI patients needs exploration for efficacy and tolerability. Objectives Evaluate ketamine’s clinical effectiveness and safety (PHQ-9, GAD-7, PCL-5 scores) in post-TBI patients, comparing IM, intranasal, and oral routes. Methods Design:...
Approximately 80% of individuals diagnosed with major depressive disorder (MDD) report symptoms of insomnia. Glutamatergic modulators, such as ketamine, are reported to be effective for the treatment of depressive symptomatology in adults with MDD. Disrupted glutamate homeostasis is linked to poor sleep quality and sleep disorders. Herein, we sought to systematically determine the effect of...