We investigated the potential role of the opioid system in modulating glutamatergic effects of ketamine administration in major depressive disorder. Twenty-six adults with major depressive disorder participated in a double-blind crossover study, receiving oral placebo or 50 mg naltrexone before an intravenous infusion of 0.5 mg per kg ketamine. Brain glutamatergic activity in the anterior...
To investigate the effect of intraoperative low-dose esketamine administered at anesthesia induction on postoperative quality of recovery in total laparoscopic hysterectomy. One-hundred six female patients scheduled for elective total laparoscopic hysterectomy were randomly divided into saline group (group P) and esketamine group (group S). Group P received induction with normal saline,...
Objectives: (R)-ketamine hydrochloride injection is a novel, rapid-acting antidepressant for the treatment of treatment-resistant depression. The aim of this study was to assess the pharmacokinetics, safety, and tolerability of (R)-ketamine hydrochloride injection in healthy Chinese subjects following ascending single intravenous doses ranging from 10.0 mg to 180 mg. Methods: This randomized,...
OBJECTIVES: Ketamine is a prototypical rapid-acting antidepressant for treatment-resistant bipolar depression (TRBD), yet many patients do not achieve a meaningful response. This study explored features of ketamine nonresponse in TRBD. METHODS: In a post hoc analysis of a naturalistic study, 35 TRBD patients received a four-week ketamine regimen (intravenous 0.5 mg/kg or oral 2.0/2.5 mg/kg)....
Depression during pregnancy is often overlooked and undertreated. Ketamine has been shown to exert prompt and sustained antidepressant effects in patients with depression, although concerns of potential neurotoxicity prohibit its use in pregnant women. Here, we aim to investigate the neurobehavioral effects of subanesthetic ketamine on pregnant mice and their offspring. We found that pregnant...
Psychiatry ResearchJuly 19, 2025Kevin J Li, Natalie E Slama, Ingrid L Chen et al.2 citations
Interventional psychiatric procedures (IPPs) such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and ketamine intravenous treatments (KIT) are widely used for treatment resistant depression (TRD), but we lack studies of their real-world impact compared to standard outpatient medication management (MM). Longitudinal electronic health records of 22,481 patients in a...
PharmaceuticalsJuly 19, 2025Daniel Szawarnoga, Joanna Fojcik, Michał Górski et al.1 citation
Background: Insomnia, as one of the most common sleep disorders, is a significant health problem, especially among patients suffering from drug-resistant depression. Problems related to the quality of sleep in that population can significantly affect the effectiveness of treatment and quality of life, which is why it is necessary to search for effective therapeutic interventions in this area....
Ketamine has emerged as a versatile therapeutic agent with applications spanning anesthesia, pain management, and psychiatric disorders. This review examines ketamine's clinical utility across diverse administration routes, including intravenous, intramuscular, intranasal, and oral, emphasizing the need to individualize dosing regimens. We explore factors influencing ketamine dosing, such as...
Ketamine’s rapid action and diverse physiological effects have made it an important drug in both anesthesia and mental health treatment. Clinically, it offers unique dissociative anesthetic properties, preserving stable vital signs during sedation and analgesia. Beyond its numbing effect, studies explore its influence on N-methyl-D-aspartate (NMDA) receptors and wider neurochemical systems...
Cerebrolysin (CBL), a peptide derived from pig brain, is recognized for its neuroprotective and anti-inflammatory properties. This research aimed to investigate the effects of CBL on anxiety- and depression-like behaviors, spatial memory, the tryptophan/kynurenine (TRP/KYN) pathway, and inflammation in the prefrontal cortex (PFC) of a mouse model for schizophrenia. Thirty-six male BALB/c mice...
Aeromedical transfer of acutely unwell mental health (AMH) patients presents potential risks to patient, staff and aircraft. Pharmacological options to reduce risk can impair consciousness, risking airway compromise and management challenges in-flight. Pre-emptive intubation carries associated patient risks and requires a receiving intensive care unit bed. This study aimed to assess the risk of...
This study aims to investigate the acute and sustained antidepressant effects of repeated ketamine infusions in patients with treatment-resistant depression (TRD), and to identify early metabolomic changes predictive of treatment outcomes using metabolome analyses. This open-label study investigated the effects of four intravenous ketamine infusions (0.5 mg/kg) administered over 2 weeks in 30...
Alzheimer's disease (AD) is the leading cause of dementia. There are limited approved medications that delay cognitive decline or lessen neuropsychiatric symptoms. Numerous clinical trials for AD using a single drug administration have failed to meet therapeutic endpoints, which is most likely due to the complexity of AD. A multimodal therapeutic intervention is more likely to improve symptoms...
Intranasal (IN) esketamine was approved as a therapy for treatment-resistant depression in March 2019. There continues to be interest in the field to better understand factors associated with response to treatment. The aim of the current study is to assess the association between BMI and response to esketamine. A retrospective analysis was conducted on all patients treated with intranasal...
The endogenous opioid system is thought to play a role in the placebo antidepressant response. A recent trial comparing the rapid antidepressant effects of ketamine versus placebo in surgical patients, some of whom were on chronic opioid therapy, revealed a substantial placebo effect. This finding provided an opportunity to test the hypothesis that opioid agonist exposure interacts with placebo...
Ketamine and electroconvulsive therapy (ECT) are among the recommended treatments for treatment resistant depression (TRD). However, there is a subset of patients who do not respond to either treatment, making it insufficient to address their condition. To determine the efficacy of concurrent therapy with ECT and intravenous racemic ketamine in TRD. This retrospective study included a total of...
Depression and PTSD are prevalent psychiatric conditions that often co-occur and significantly impact quality of life. Ketamine has emerged as a promising rapid-acting treatment for both conditions, while traditional treatments like psychotherapy typically require weeks to show effects. This study investigated whether combining ketamine with psychotherapy produces greater symptom improvement...
Depression affects hundreds of millions globally, and in 2019, esketamine, an S-enantiomer of ketamine, was approved for treatment-resistant depression (TRD). While effective, esketamine carries risks, including abuse potential and adverse effects even at low doses. As a result, ketamine's metabolite, (2R,6R)-hydroxynorketamine ((2R,6R)-HNK), has garnered attention for its potential...
The dynamic coordination of neural activity across populations of neurons is impaired in neuropsychiatric disorders. Here, we focused on the large-scale rhythmic responses induced by flickering light. These so-called steady-state visual evoked potentials (SSVEPs) are reduced in people with schizophrenia (Sz). A large body of work has identified hypofunction of the N-methyl d-aspartate receptor...
Ketamine is a synthesized anesthetic drug that was used extensively as a surgical anesthetic in the 1960s. Currently, ketamine is being investigated extensively for its potential as a treatment for depression. However, the addictive nature of ketamine has become an issue that cannot be ignored at this stage. As of now, there is no clear understanding of the changes in striatal metabolites and...