Background Subanesthetic ketamine has accumulated meta-analytic evidence for rapid antidepressant effects in treatment-resistant depression (TRD), resulting in both excitement and debate. Many unanswered questions surround ketamine’s mechanisms of action and its integration into real-world psychiatric care, resulting in diverse utilizations that variously resemble electroconvulsive therapy,...
It is almost axiomatic with most drugs and for most disorders in psychiatry that whatever elicits response and remission during the acute phase of illness will prevent relapse and recurrence of illness during the maintenance phase of treatment. Logically, this principle should apply to ketamine, as well, when the drug is used for patients with depression; thus, at the very least, the treatment,...
BACKGROUND: Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder (MDD) and suicidal ideation. METHOD: In this randomized-controlled trial, 51 participants aged 13-18...
Depressive disorders represent a significant economic and health burden globally. This is particularly evident in treatment-resistant depression (TRD), commonly defined as the absence of a satisfactory response to at least two different antidepressant trials (as defined by the U.S. Food and Drug Administration/FDA and European Medicine Agencies/EMA). The foregoing TRD cases frequently manifest...
Objective: : Treatment Resistant Depression (TRD) is commonly defined as the lack of response to two or more anti-depressants with different mechanisms of action. Up to 30% of patients diagnosed with major depressive disorder might be considered to present TRD. The objective of this study was to assess the effectiveness and tolerability of esketamine in patients diagnosed with TRD, who were...
Interim results from a Phase 3 study of esketamine nasal spray in patients with treatment‐resistant depression showed no emerging safety concerns and sustained improvement in depressive symptoms. Nearly half of study participants met criteria for remission at the end of the study's optimization/maintenance phase, the investigators reported. Study results were published online May 12, 2023, in...
Depression is a multifactorial syndrome with a variety of underlying pathological mechanisms. While ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, exhibits a rapid antidepressant action in the central never system (CNS), the potential addiction and psychotomimetic adverse effects of ketamine limit its chronic use in clinical practice. Therefore, it is necessary to discover an...
A large‐scale open‐label trial conducted at electroconvulsive therapy (ECT) clinics has found that twice‐weekly dosing of ketamine was noninferior to three sessions a week of ECT in patients with treatment‐resistant major depression. Relapse rates during a 6‐month follow‐up period after the initial 3‐week treatment period were higher among patients receiving ECT than patients receiving...
Medical Aid in Dying (MAiD) is the act of a healthcare provider ending a patient's life, at their request, due to unbearable suffering from a grievous and incurable disease. Access to MAiD has expanded in the last decade and, more recently, it has been made available for psychiatric illnesses in a few countries. Recent studies have found that such psychiatric requests are rapidly increasing and...
Ketamine has been increasingly used as a rapid-onset antidepressant in specific clinical settings. However, as a psychedelic reagent, the potential of physical and psychological dependence limits its clinical use. Here, we added retigabine, a KCNQ channel opener, as an adjunctive treatment to observe its effect on ketamine's antidepressant property in a forced swim test in both male and female...