Após concluir esta atividade, os participantes deverão ser capazes de: Analisar os mecanismos farmacodinâmicos da cetamina, incluindo sua ação primária como antagonista do receptor NMDA e efeitos secundários sobre os receptores AMPA, sistemas opioides e vias de neuroplasticidade, a fim de otimizar a seleção do tratamento para pacientes com depressão resistente ao tratamento. Avaliar cenários...
After completing this activity, participants should be able to: Analyze the pharmacodynamic mechanisms of ketamine, including its primary action as an NMDA receptor antagonist and secondary effects on AMPA receptors, opioid systems, and neuroplasticity pathways, to optimize treatment selection for patients with treatment-resistant depression. Evaluate clinical scenarios to determine when...
Na het voltooien van deze activiteit moeten deelnemers in staat zijn om: De farmacodynamische mechanismen van ketamine te analyseren, inclusief de primaire werking als NMDA-receptorantagonist en secundaire effecten op AMPA-receptoren, opioïde systemen en neuroplasticiteitspathways, om de behandelkeuze voor patiënten met therapieresistente depressie te optimaliseren. Klinische scenario's te...
Ketamine infusion therapy has gained recognition as an innovative treatment for treatment-resistant depression (TRD), demonstrating rapid and robust antidepressant effects. Its therapeutic promise is increasingly understood to involve molecular and neurobiological processes that promote neural plasticity and cognitive flexibility. These changes may create a unique window for psychotherapeutic...
Arketamine, the (R)-enantiomer of (R,S)-ketamine, shows even greater rapid and sustained antidepressant-like effects in rodent models compared to esketamine, yet the underlying mechanisms remain unclear. In this study, we used the chronic social defeat stress (CSDS) model to investigate how arketamine exerts its antidepressant-like effects. We found that activating cAMP response element-binding...
Treatment-resistant major depression (TRD) poses a significant challenge in psychiatry due to the limited response to conventional therapies. Subanesthetic dose intravenous (IV) ketamine has emerged as an effective therapeutic option, providing rapid effects on depressive and suicidal symptoms. This article outlines the ketamine infusion protocol implemented in a general hospital, following...
These two cases highlight the utility of a focused, structured clinical phenomenological interview in measuring treatment effectiveness in subjective experience. Two male patients, aged 35 and 27, of Serbian ethnicity with treatment-resistant depression were treated with nasal esketamine, with clinical progress monitored using both the Montgomery-Åsberg Depression Rating Scale (MADRS) and the...
Scientific ReportsJuly 8, 2025Beenish Asrar, Nouman Ali, Imran Ali et al.
Major depressive disorder (MDD) and Attention-deficit hyperactivity disorder (ADHD) are pervasive psychiatric disorders characterized by impaired memory, sustained attention/motivation, and depression. FDA-approved Ketamine is an antidepressant drug but it affects cognitive abilities. Methylphenidate is the drug used for the treatment of ADHD. Chronic treatment overcomes attention and mental...
Research into psychedelics has gained renewed interest due to their potential to address psychiatric, neurological, and other peripheral conditions. These substances offer long-term therapeutic benefits, contrasting with the side effects and limitations of current psychiatric medicines. This study examines the legislations and regulatory frameworks for psychedelics in Australia, Canada, The...
ObjectivesTo review the available evidence, key deliberations, and potential influences behind the Pharmaceutical Benefits Advisory Committee's (PBAC's) conditional recommendation for esketamine to be listed on the Pharmaceutical Benefits Scheme (PBS).ConclusionsThis paper forms part 2 of the esketamine story in Australia-its handling by the Therapeutic Goods Administration (TGA) and,...
We aimed to investigate the relationship between changes in resting-state functional connectivity in a subregion of the hippocampus and the antidepressant effects of esketamine as well as to identify potential neuroimaging markers of the treatment outcomes. Twenty-nine patients with major depressive disorder (MDD) received six intravenous infusions of esketamine. All patients completed the...
The available therapeutic options for post-stroke depression patients are limited. Although SSRIs are the most commonly prescribed antidepressants, their slow onset of action and the higher risk of adverse effects or contraindications have led to an urgent need to develop fast-acting and highly specific antidepressants tailored to the needs of PSD patients. Therefore, ketamine has drawn...
Journal of patient safetyJuly 7, 2025Tania Johnston, Christopher Mistiades, Roxane Beaumont-Boileau et al.
In Western Canada, British Columbia Emergency Health Services (BCEHS) aimed to enhance prehospital pain management by authorizing Primary Care Paramedics (PCP) to administer intranasal (IN) ketamine. The objective of this study is to describe patient safety implications of expanding PCP scope to include IN ketamine. This retrospective, observational study reviewed patient care records of the...
Molecular PsychiatryJuly 7, 2025Dongsun Park, Gwangho Lee, Won-Gyu Lee et al.7 citations
Major depressive disorder is a debilitating condition, with many patients unresponsive to conventional monoaminergic antidepressants. Rapid-acting antidepressants such as ketamine and psilocybin offer promising alternatives, relieving symptoms within hours. Ketamine, an NMDA receptor antagonist, and psilocybin, a serotonergic psychedelic primarily targeting 5-HT2A receptors, both enhance...
Postoperative delirium and other forms of perioperative neurocognitive deficits occur commonly in older adult patients. Ketamine, administered either before or during general anaesthesia, may have cognitive-sparing properties owing to its ability to reduce neuroinflammation, increase neurotrophin levels, or allow reductions in the doses of other general anaesthetic drugs. However, the efficacy...
Contradictory evidence has emerged regarding the role of the mu opioid receptor (MOR) in the antidepressant actions of (R,S)-ketamine. Here, we used the long-acting MOR-selective antagonist methocinnamox (MCAM) to determine the contribution of MOR to the actions of (R,S)-ketamine and the more selective N-methyl-D-aspartate receptor (NMDAR) antagonist fluoroethylnormemantine (FENM) against...
Background: Ketamine and esketamine have been reported to rapidly alleviate various parameters of suicidality, with antisuicidal effects that may be independent of their rapid-acting antidepressant effects. However, it remains unclear whether ketamine and/or esketamine are associated with the emergence or worsening of suicidality. Methods: In this global observational pharmacovigilance cohort...
Ketamine is used frequently as an adjunct for general anaesthesia, exerting analgesic and opioid-sparing properties at lower doses and psychotomimetic effects at higher doses. All dose ranges may have effects on the incidence of postoperative delirium, but clinical trials have been equivocal. We hypothesised that intra-operative low-dose ketamine is associated with a lower risk of postoperative...
Psychedelic-assisted therapies and ketamine are two modalities gaining attention in psychiatry for treating conditions such as depression, PTSD, and substance use disorders. However, perceptions of these treatments vary globally. This study explores the familiarity, attitudes, and perceptions of Jordanian physicians and medical students toward psychedelic substances, addressing a gap in Middle...
Esketamine exerts analgesic effects and has pharmacological properties of bronchodilation and elevation of mean arterial pressure, making it an interesting analgesic agent for patients with ARDS. Therefore, we conducted a randomized controlled trial comparing the effects of esketamine/midazolam and remifentanil/midazolam on respiratory mechanics and oxygenation in mechanically ventilated...