Anhedonia is a key symptom of bipolar depression and a target of ketamine's rapid antidepressant effects. However, many patients with treatment-resistant bipolar depression (TRBD) do not respond. This study aimed to identify clinical and sociodemographic characteristics that are associated with nonresponse of anhedonia following short-term ketamine treatment in TRBD. A retrospective analysis...
Objective: To investigate neurobiological mechanisms through which esketamine produces rapid antidepressant effects in adolescents with major depressive disorder (MDD), focusing on structural changes in the rostral anterior cingulate cortex (rACC) and associated molecular pathways. Method: A total of 49 adolescents (13-18 years of age) with DSM-5 MDD were randomized to receive intravenous...
Ketamines should be used cautiously in bipolar disorder due to its potential to trigger psychosis, and is best reserved for short-term (one-month) treatment of severe depression that might otherwise require hospitalization. While both ECT and TMS are effective for bipolar depression, ECT acts faster and is preferred for more severe cases with psychotic features, with studies showing remission...
Yue, Luo, and colleagues discovered that adenosine signalling is the common underlying mechanism of rapid acting antidepressant therapies, unifying the effects of ketamine, ECT and acute intermittent hypoxia. They use genetically encoded sensors, along with extensive mechanistic dissection, to show that all three induce adenosine surges in mood-regulatory circuits via A1 and A2A receptor...
Background: Suicidal ideation (SI) represents a clinical challenge in patients with treatment-resistant depression (TRD), and the management of this condition should be as rapid and effective as possible. Intranasal Esketamine has shown promise in patients with TRD due to its rapid onset of action on both SI and depressive symptoms. Since this medication has been recently approved, real-world...
Major depressive disorder (MDD) is a multifactorial mental health condition involving genetic, environmental, and neurobiological factors. Conventional antidepressants such as fluoxetine, a selective serotonin reuptake inhibitor, require weeks to exert therapeutic effects, whereas ketamine and esketamine act rapidly via glutamatergic modulation. These drugs may also converge on the inhibition...
Depression is a common, debilitating, and potentially life-threatening mental disorder affecting individuals across all age groups and populations. It represents one of the major challenges of contemporary medicine. It is estimated that more than 300 million people worldwide are affected, and patients with major depressive disorder (MDD) exhibit a significantly increased risk of suicide,...
Cancer patients frequently experience pain and depression, yet current guidelines address these conditions separately and do not recommend a single agent for concurrent management. Ketamine and its S-enantiomer esketamine, through N-methyl-D-aspartate receptor antagonism and glutamate modulation, may offer dual benefit. This paper examined ten clinical studies published between 2018 and 2024...
Treatment-resistant depression (TRD) remains a significant public-health challenge, with many patients failing to respond to conventional therapies. Ketamine has emerged as a rapid-acting intervention, but quantitative outcomes alone do not capture patients' lived experiences, which shape engagement, acceptability, and adherence. We conducted a narrative review of qualitative and mixed-methods...
Borderline Personality Disorder (BPD) is characterised by altered perception of self, mood changes, and suicidal ideation. The traditional treatments of BPD, including psychotherapy, fail to provide an immediate response in susceptible patients. However, recent literature has shed light on the use of Ketamine as intervention for suicidal ideation in BPD patients, as well as for patients with...