Pharmacology, Biochemistry, and Behavior
June 1, 2019
Lijia Chang, Kai Zhang, Yaoyu Pu et al.
174 citations
The N-methyl-d-aspartate receptor (NMDAR) antagonist (R,S)-ketamine produces rapid and sustained antidepressant effects in treatment-resistant patients with depression although intranasal use of (R,S)-ketamine in ketamine abusers is popular. In March 5, 2019, nasal spray of (S)-ketamine for treatment-resistant depression was approved as a new antidepressant by the US Food Drug Administration....
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
Despite the exciting findings of high rates of response and remission following a single dose of ketamine, there are limited reports of the long-term safety and efficacy of ketamine. While the reported studies of low-dose (subanesthetic) ketamine for use in depression have not generated significant safety concerns, the field awaits further evidence of the long-term safety of ketamine. Concerns...
May 14, 2019
Ketamine was developed as an anesthetic and less potent form of phencyclidine (PCP) by Drs. Edward Domino and Calvin Stevens. The drug was termed a "dissociative anesthetic" in part because subjects became disconnected from their environment and in part because sensory inputs can reach cortical areas but are not always perceived in association areas. It was approved by the US Food and Drug...
May 14, 2019
Several studies have shown that ketamine can lead to a rapid reduction in suicidal ideation. Ketamine’s rapid effect on suicidal ideation seems at least partially independent of its antidepressant effect. Given the lack of long-term follow-up, the concern for long-term exposure to ketamine, and the transient nature of the effect of a single-dose of ketamine, more long-term data are needed...
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...
May 14, 2019
Ketamine has been shown to rapidly improve mood within a few hours or days of administration. This effect can last for a week or more following a single administration of ketamine. The safety of long-term ketamine exposure is not well known. Future research is urgently needed to better understand long-term risks as well as evidence-based treatment regimens.
Physiology & Behavior
May 1, 2019
Kristofer J Schoepfer, Caroline E. Strong, Samantha K Saland et al.
Subanesthetic ketamine (KET) elicits rapid, robust, but transient antidepressant effects. KET's antidepressant actions can be augmented and maintained for a longer duration when repeatedly delivered. However, KET is recreationally abused, raising long-term treatment safety concerns. Women are more likely than men to seek treatment for depression, escalate from casual to compulsive drug use, 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...
Behavioural Brain Research
May 1, 2019
Wei Wang, Le Liu, Xiu Yang et al.
HighlightsSusceptible mice showed depressive‐like behaviors upon chronic social defeat stress.Plasma corticosterone concentration might predict susceptibility to chronic stress.Abnormal glucocorticoid receptor expression was associated with susceptibility.Ketamine exerted antidepressant effect via normalizing HPA axis response. &NA; Chronic stress is an important factor for depression. Most...
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...
Journal of Affective Disorders
May 1, 2019
Wei Zheng, Xiaohong Li, Xiao-Min Zhu et al.
57 citations
BACKGROUND Adjunctive ketamine with electroconvulsive therapy (ECT) has been investigated for treating major depressive disorder (MDD), but the findings have been inconsistent. AIM This is an updated meta-analysis of the efficacy and safety of ketamine augmentation of ECT in the treatment of MDD. METHODS Randomized controlled trials (RCTs) reporting on the efficacy and safety of ketamine and...
PLoS One
April 15, 2019
P. Fitzgerald, Jessica Yen, B. Watson
Major depression is a stress-linked disease with significant morbidity and the anesthetic drug ketamine is of growing interest in the treatment of depression, since in responsive individuals a single dose has rapid (within hours) antidepressant effects that can be sustained for over a week in some instances. This combination of fast action and a therapeutic effect that lasts far beyond the...
The Journal of Clinical Psychiatry
April 15, 2019
Joshua D. Rosenblat, André F. Carvalho, Madeline Li et al.
111 citations
OBJECTIVE: Intravenous (IV) ketamine has rapid and robust antidepressant effects; however, poor accessibility of the IV route often limits its use. Numerous alternative routes of administration are being investigated. Oral ketamine is particularly appealing for its ease of use with the potential for high accessibility. The objective of the current systematic review, in accordance with PRISMA,...
Advanced Biomedical Research
April 10, 2019
G. Kheirabadi, M. Vafaie, Dorna Kheirabadi et al.
Background: Achieving a rapid onset and durable methods of treatment for major depressive disorders is an issue pursuing in psychiatry. This study was designed to assess the therapeutic efficacy of intravenous (IV) ketamine injection in controlling depressive symptoms in comparison with electroconvulsive therapy (ECT) in major depressed disordered patients. Materials and Methods: Thirty-two...
Neuroimage
April 5, 2019
Duan Li, George A. Mashour
103 citations
Ketamine is a unique drug that has psychedelic and anesthetic properties in a dose-dependent manner. Recent studies have shown that ketamine anesthesia appears to maintain the spatiotemporal complexity of cortical activation evoked by transcranial magnetic stimulation, while a psychedelic dose of ketamine is associated with increased spontaneous magnetoencephalographic signal diversity....
Perspectives In Psychiatric Care
April 2019
Brittany Carnley Steelman
Currently only one-third of patients treated for depression enjoy complete remission of their negative symptoms. This paper explores ketamine research as it applies to understanding and treating mood illnesses. Ketamine's rapid antidepressant effect implicates downstream signal transduction involving the spontaneous transmissions associated with ketamine's action at the NMDA receptor. Better...
The FASEB Journal
April 1, 2019
Melodi Ann Bowman, Melissa Vitela, W. Anthony Owens et al.
Twenty percent of adults are diagnosed with major depressive disorder, which is typically treated with selective serotonin reuptake inhibitors (SSRIs). However, SSRIs take approximately six weeks to produce therapeutic effects. Recently, low doses of ketamine, a noncompetitive N‐methyl‐ D‐aspartate (NMDA) receptor antagonist, have been shown to produce rapid and long‐lasting antidepressant...