Background: Treatment-resistant depression (TRD) has a poor response to clinical treatment. Patients with TRD do not respond adequately to standard antidepressants. Even after receiving a full dose and sufficient duration of combined antidepressant therapy, significant improvement is still difficult to achieve. At present, electroconvulsive therapy (ECT) remains a clinically effective method...
Conclusions: Ketamine and esketamine reduced long-term ED visits for suicidality in individuals with TRD. Further longer-term follow-up research is encouraged to ascertain if these benefits on suicidality reduction are mood state dependent or reflect an independent mechanism.
Motivation: The exact mechanism of action of the rapid acting acting antidepressant ketamine is unknown. Goal(s): Investigation of the functional connectivity changes after acute ketamine in relation to receptor density. Approach: In a double blind placebo controlled clinical trial an infusion of ketamine or placebo was administered during resting state fMRI at 3T and functional connectivity...
Previous work has identified four correlated factors (depression phenotypes) using the Montgomery-Åsberg Depression Rating Scale (MADRS)- Sadness, Negative Thoughts, detachment/Interest and Activity (IA), and Neurovegetative. We explored treatment responses to ketamine based on these 4 phenotypes in treatment resistant depression (TRD). This is a secondary analysis of data from an open-label...
This review examines ketamine's neurotoxic potential across preclinical and clinical studies. The authors synthesized data from preclinical models, then integrated findings from human clinical trials of esketamine and observational studies in recreational users. Animal studies have found that repeated or high-dose subanesthetic ketamine administration results in consistent excitotoxic neuronal...
Electroconvulsive therapy (ECT) has potent antidepressant effects yet can lead to neurocognitive side effects. Ketamine is a rapid-acting antidepressant, which may be an alternative to ECT. Few have directly compared the cognitive effects of ECT and ketamine treatment. We compared cognitive effects of intravenous ketamine and ECT in patients with treatment-resistant depression (TRD), collected...
Introduction: This is the first randomized controlled trial to use both qualitative and quantitative methods to evaluate the effects of a combined sensory intervention that included mindfulness, music, and a light-occluding eye mask during antidepressant-dose ketamine treatment for depression. Methods: Forty-three participants with unipolar depressive disorder enrolled in the study; 22...
CureusSeptember 2025Muhammad Abbas, David B Adams, Jack Noto et al.
Management of treatment-resistant depression (TRD) is complex and frustrating for patients, requiring several treatment courses before (or without) achieving remission. This investigation aims to highlight and analyze real-world instances of using esketamine for patients with TRD who have failed electroconvulsive therapy (ECT). Four case reports from a single Hackensack-Meridian care center are...
Treatment-resistant depression (TRD) remains a major clinical challenge, affecting nearly one-third of individuals with major depressive disorder (MDD) who fail to respond to standard antidepressant therapies. Esketamine, the S-enantiomer of ketamine, has emerged as a novel therapeutic option. Esketamine, initially introduced as an add-on therapy, has more recently also received recognition for...
INTRODUCTION Dysfunction in amygdala networks has been implicated in major depressive disorder (MDD). Pharmacological treatments, such as esketamine and sertraline, are believed to exert their antidepressant effects by modulating amygdalar activity. This study aimed to investigate the relationship between changes in dynamic functional connectivity (dFC) within amygdala subregions and treatment...