Chronic stress is a risk factor for depression and may contribute to treatment resistance. This historical cohort study examined the association between baseline perceived stress, measured with the Perceived Stress Scale (PSS), and response to (es) ketamine in treatment-resistant depression (TRD). Adult TRD patients who received intravenous racemic ketamine or intranasal esketamine were...
Approximately 30 % of patients with treatment-resistant depression (TRD) respond to ketamine; however, no replicable predictors of response have been reported. The imbalance between excitatory and inhibitory neurotransmissions may be implicated in the mechanism of action of ketamine. This study aimed to evaluate whether the ratio of glutamate and glutamine (Glx) to GABA levels at baseline in...
Introduction and Background Patients with depression who fail to respond to at least two antidepressants in their current episode are considered to have Treatment Resistant Depression (TRD). ECT is an effective treatment of TRD but cognitive side effects limit its use. Ketamine elicits a rapid antidepressant response in sub-anesthetic repeated doses. ECT and ketamine may be modulating the...
We read a recent article published by CNN titled “Ketamine offers lifeline for people with severe depression, suicidal thoughts1” with great interest. The article traces the story of a man with a 35-year history of severe refractory depression, suicidal ideation, and recent suicide attempts who was successfully treated with ketamine as a last resort after failing dozens of other pharmacologic...
IMPORTANCE The comorbidity of major depressive disorder (MDD) and alcohol use disorder (AUD) is often treated inadequately. This study evaluated the impact of adding the opioid receptor blocker, naltrexone, to the NMDA glutamate receptor antagonist, ketamine, for the treatment of MDD comorbid with AUD. In so doing, it also attempted to shed light on the contribution of opioid receptor...
Abstract This review systematically summarizes the research progress of ketamine and its interaction with specific brain regions in the context of neuropathic pain comorbid with depression. As a non-competitive inhibitor of N-methyl-D-aspartate (NMDA) receptors, Ketamine exerts complex mechanisms and controversial topic. The structure and function of NMDA receptors, as well as the binding sites...
Structured Abstract Importance Ketamine has well known dissociative, analgesic, and antidepressant properties, but it is unknown whether the neurophysiologic effects that are associated with these properties can be modulated separately from one another. Given prior studies that link specific cortical oscillations with specific therapeutic effects, it is likely that modulating selective aspects...
OBJECTIVE To evaluate the safety of esketamine in bipolar depression, focusing on suicide-related outcomes and manic switch across timeframe and demographic subgroups. METHODS This retrospective cohort study was conducted in May 2025 using data from the TriNetX global collaborative network. Adults with bipolar depression treated with esketamine plus a mood stabilizer were propensity...
Background: Major depressive disorder (MDD) is a severe condition marked by persistent sadness and functional impairment. While electrocompulsive therapy (ECT) is effective for treatment-resistant cases, the comparative effects of propofol and ketamine as anesthetic agents remain unclear. Objective: To compare the effects of propofol and ketamine anesthesia on depression severity in patients...
Frontiers in PsychiatryAugust 4, 2025Fernando Mora, J. Ramos-Quiroga, Enrique Baca-García et al.5 citations
Introduction Depression is a highly prevalent disease that severely impacts the life of patients. Inadequate response to at least two antidepressants despite adequacy of treatment and adherence is known as treatment-resistant depression (TRD), which entails a higher social and economic burden than non-resistant major depression. The lack of consensus on the definition of TRD and other aspects...
Ketamine is a dissociative anesthetic used in subanesthetic doses with analgesic and anti-depressive properties. However, its mechanistic effects on neuronal signaling and circuit function remain underexplored. We address this shortcoming by employing multi-neuronal imaging in the simple nematode C. elegans that allows measurement of neuron activity across the animal's entire head with...
Forty per cent of major depression patients are resistant to antidepressant medication. Thus, it is necessary to search for alternative treatments. Melatonin (N-acetyl-5-hydroxytryptamine) enhances neurogenesis and neuronal survival in the adult mouse hippocampal dentate gyrus. Additionally, melatonin stimulates the activity of Ca2+/Calmodulin-dependent Kinase II (CaMKII), promoting dendrite...
Abstract Background Ketamine, a rapidly acting antidepressant, requires dosing in clinic because of strong symptoms of dissociation and sedation after IV/IN dosing. This need for dosing in clinic limits capacity to treat patients with Treatment Resistant depression (TRD). We hypothesize that ketamine formulations that maximize ketamine’s first pass metabolism and delay absorption will have...
Abstract Background As accumulating evidence suggests ketamine's antisuicidal properties, there has been growing interest in elucidating its underlying mechanisms and predictive factors for treatment response. However, the predictive power of several demographic and clinical characteristics varied across previous studies. Additionally, some potential predictors, such as baseline depression...
L'EncephaleAugust 1, 2025Yara Bachir, Raymond Kassab, C. Hallal et al.
OBJECTIVE This case report explores the efficacy of intravenous Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and functional neurological disorder (FND). CASE DESCRIPTION The patient, with a history of multiple suicide attempts and...
Ketamine has emerged as a promising treatment for major depression, though its efficacy and safety remain incompletely characterized in older adults. This systematic review synthesizes current evidence for ketamine in geriatric depression. A search of PubMed, EMBASE, and PsycINFO was conducted. Prospective clinical trials were included, with age restriction to participants ≥60 years applied at...
Background & Aims Esketamine, a promising treatment for treatment-resistant depression, has shown potential advantages over traditional antidepressants. However, its mechanisms remain unclear. This study explores how esketamine alleviates depressive behaviors through activation of the BDNF/TrkB/PI3K/AKT signaling pathway. Methods Using a Chronic Unpredictable Mild Stress (CUMS) rat model,...
INTRODUCTION: Methamphetamine use disorder (MeUD) is a debilitating condition with no FDA-approved pharmacotherapies that has been associated with poor neurological, psychiatric and cardiovascular outcomes, particularly among low-income populations. The use of methamphetamine also increases risks for sexually transmitted infections (STIs) by reducing behavioural inhibitions while enhancing...
Treatment-resistant depression (TRD) is associated with immune dysregulation. Ketamine, a rapid-acting antidepressant, may exert effects via immunomodulation. The aim was to examine ketamine’s impact on immune markers in TRD, including T-cell subsets, cytokines, and in vitro T-cell responses. Eighteen TRD inpatients received 0.5 mg/kg iv ketamine. Blood was sampled at baseline, 4 h, and 24 h to...
Mystical experiences are powerful experiences that may have therapeutic value. Ketamine, a dissociative anesthetic, has shown potential to induce mystical experiences. However, little research has explored this phenomenon, particularly in treatment-resistant depression. We analyzed clinical data from 60 veterans with treatment-resistant depression receiving a total of 189 ketamine treatments....