The Brown University Psychopharmacology Update
July 1, 2019
A study examining the effects of single, repeated, and maintenance doses of ketamine on patients with treatment‐resistant depression has found cumulative and sustained antidepressant effects from six infusions administered three times a week over 2 weeks. The study also found that among responders to the repeated infusions, antidepressant response was generally maintained with weekly infusions...
Psychiatry and Clinical Neurosciences
June 19, 2019
Kenji Hashimoto
325 citations
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...
CNS Spectrums
June 19, 2019
Gregor Hasler
31 citations
In major depression, remission rate in response to monoaminergic antidepressant is around 50%. The lack of strong synergies between classical antidepressants and psychotherapy may be due to the molecular effects of classical antidepressants. They modulate synapses but they do not substantially influence synaptogenesis. They also increase brain-derived neurotrophic factor (BDNF). However, for...
JAMA Psychiatry
June 5, 2019
Ella Daly, Madhukar H. Trivedi, Adam Janik et al.
766 citations
Importance: Controlled studies have shown short-term efficacy of esketamine for treatment-resistant depression (TRD), but long-term effects remain to be established. Objective: To assess the efficacy of esketamine nasal spray plus an oral antidepressant compared with an oral antidepressant plus placebo nasal spray in delaying relapse of depressive symptoms in patients with TRD in stable...
JAMA
May 24, 2019
Ole Köhler‐forsberg, Cristina Cusin, Andrew A. Nierenberg
18 citations
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.
New England Journal of Medicine
May 22, 2019
Jean Kim, Tiffany R. Farchione, Andrew Potter et al.
Esketamine for Treatment-Resistant Depression The FDA has approved esketamine, the first antidepressant in a new class, for treatment-resistant depression. The agency weighed the drug’s rapid onset...
American Journal of Psychiatry
May 21, 2019
Vanina Popova, Ella Daly, Madhukar H. Trivedi et al.
879 citations
OBJECTIVE: About one-third of patients with depression fail to achieve remission despite treatment with multiple antidepressants. This study compared the efficacy and safety of switching patients with treatment-resistant depression from an ineffective antidepressant to flexibly dosed esketamine nasal spray plus a newly initiated antidepressant or to a newly initiated antidepressant (active...
May 14, 2019
Ketamine has emerged as the prototypical rapid-acting antidepressant. Early efficacy studies showed a high rate of response (64% to 71%) to a single dose of ketamine among individuals with treatment-resistant depression. Later clinical reports of the effectiveness of ketamine in clinical samples demonstrated a response rate of approximately 50%. This discrepancy between efficacy and...
Molecular Neurobiology
May 2019
Wenyan Cui, Yuping Ning, Wu Hong et al.
Depression is a worldwide illness with a significant impact on both family and society. Conventional antidepressants are ineffective for more than 30% of patients. In such patients, who have what is called treatment-resistant depression (TRD), inflammatory biomarkers are expressed excessively in both the central nervous system (CNS) and the peripheral blood. Ketamine, a glutamate receptor...
Indian Journal of Psychiatry
May 1, 2019
Amit Jagtiani, H. Khurana, N. Malhotra
15 citations
Background: It is well known that depression improves faster with electroconvulsive treatment (ECT) than with antidepressant medications. N-methyl-D-aspartate-receptor antagonists (ketamine) have been shown to have rapid antidepressant effects when given as an intravenous infusion. Faster recovery with ECT is likely when used with ketamine as anesthetic. Aim: The aim of the study is to compare...