Pharmaceuticals
April 24, 2026
Pietro Carmellini, Alessandro Cuomo, Maria Beatrice Rescalli et al.
Background/Objectives: Major depressive disorder (MDD) remains a leading cause of disability worldwide and exhibits substantial biological heterogeneity that is not adequately captured by current symptom-based diagnostic systems. While the classical monoamine hypothesis has historically guided antidepressant development, it does not fully account for variability in treatment response, delayed...
Frontiers in Neurology
April 23, 2026
Jing Cao, ZiYuan Wang, GeGe Lv et al.
Background Paclitaxel (PTX), a broad-spectrum anti-tumor drug, is extensively employed as a first-line chemotherapy for solid tumors, including lung and breast cancers. However, it induces chemotherapy-related pain and anxiety in over 53% of patients. S-ketamine, the S-enantiomer of ketamine, exerts rapid antidepressant effects. In this study, we established a PTX model to examine the effects...
medRxiv Preprint Server
April 23, 2026
Willys Cantenys, Zeynep Yoldas, Luc Masset et al.
preprint
Background Ketamine is a rapid-acting antidepressant that produces acute dissociative symptoms. In routine care, the respective contributions of therapeutic expectations and dissociative symptoms to antidepressant response, and the directionality of their associations with depressive symptom change, remain poorly characterized.
April 21, 2026
Samuel T. Wilkinson
Reserveer ketamine of esketamine voor patiënten bij wie twee tot vier adequate antidepressieve behandelingen onvoldoende effect hebben gehad. Weeg ook de ernst mee; bij milde gevallen is dit doorgaans niet geïndiceerd. Overweeg esketamine bij acute suïcidaliteit bij therapieresistente depressie, ondanks de negatieve studieresultaten. De placebogroepen ontvingen uitstekende intramurale...
April 21, 2026
Samuel T. Wilkinson
Wanneer een patiënt terugvalt na het afbouwen van ketamine of esketamine, overweeg dan een herstart van een inductiekuur (tweemaal per week gedurende enkele weken, vervolgens geleidelijk spreiden). Bij ketamine of esketamine treden dysfore reacties op bij ongeveer 1 op de 200-300 behandelingen. Veel hiervan verdwijnen met ondersteunende zorg alleen; andere vereisen een kortwerkend...
April 21, 2026
Samuel T. Wilkinson
Na het voltooien van deze activiteit dienen deelnemers in staat te zijn om: Geschikte kandidaten voor ketamine of esketamine te identificeren op basis van eerdere behandelmislukkingen, ernst van de aandoening, middelengebruiksgeschiedenis en relevante contra-indicaties. Strategieën te beschrijven voor onderhoudsdosering, afbouw en het omgaan met snelle terugval na het staken van ketamine of...
April 21, 2026
Samuel T. Wilkinson
Reserve ketamine or esketamine for patients who have failed two to four adequate antidepressant trials. Weigh severity too; mild cases may not warrant it. Consider esketamine for acute suicidality in TRD despite the negative trial results. Placebo groups received excellent inpatient standard of care and improved substantially, masking the drug's benefit. Avoid ketamine and esketamine in active...
April 21, 2026
Samuel T. Wilkinson
After completing this activity, participants should be able to: Identify appropriate candidates for ketamine or esketamine based on prior treatment failures, severity, substance use history, and relevant contraindications. Describe strategies for maintenance dosing, tapering, and managing rapid relapse after discontinuation of ketamine or esketamine. Apply clinic-based approaches to managing...
April 21, 2026
Samuel T. Wilkinson
When a patient relapses after tapering off ketamine or esketamine, consider restarting an index course (twice weekly for a few weeks, then spread out). With ketamine or esketamine, dysphoric reactions occur in roughly 1 in 200-300 treatments. Many resolve with supportive care alone; others require a short-acting benzodiazepine such as lorazepam. For esketamine sessions, have patients fast for...
Current Pain and Headache Reports
April 21, 2026
Navy C Coggins, Hanson A Chokr, Tricia A Meyer et al.
PURPOSE OF REVIEW: Ketamine was originally developed as a dissociative anesthetic and has remained a valuable agent in anesthesia related to its ability to preserve airway reflexes and relative hemodynamic stability. Over time, its clinical applications have expanded beyond procedural sedation to include roles in pain management and psychiatry. In pain medicine, the therapeutic rationale is...
Scientific Reports
April 21, 2026
Rong Ding, Daojie Wang, Guoxin Wang et al.
Elderly colorectal cancer (CRC) patients face high risks of postoperative depression state, inadequately addressed by opioid-based analgesia. Esketamine, an NMDA receptor antagonist with rapid antidepressant effects, offers potential benefits but lacks evidence in this population. This double-blind RCT enrolled 99 elderly (≥ 65 years) CRC resection patients, randomized to three postoperative...
Translational Psychiatry
April 21, 2026
Paul A Parcon, Amanda Bardhoshi, Amanda Olsen-Dufour et al.
The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine is a robust, rapid-acting antidepressant whose molecular effects have not been fully elucidated. Phosphodiesterase-4 (PDE4), which terminates cyclic adenosine monophosphate (cAMP) activity, may underlie antidepressant response. In particular, previous studies found that whole brain binding of the positron emission tomography (PET)...
Pain Management
April 16, 2026
Theresa R. Lii, Pilleriin Sikka, Ben Deverett et al.
INTRODUCTION Ketamine shows promise for treatment-refractory chronic pain and depression, but randomized trials risk unblinding from ketamine's acute dissociative effects. Propofol sedation may mitigate this, though it has not been prospectively tested as a masking strategy outside of surgical contexts. METHODS This protocol describes a single-center, randomized, double-blind,...
Journal of Psychopharmacology
April 16, 2026
Minna Chang, Allan H. Young, Mario F Juruena
Previous systematic reviews and meta-analyses have reported impressive antidepressant effects of ketamine in treatment-resistant depression (TRD). While ketamine has been compared with electroconvulsive therapy (ECT), the gold standard treatment, the extent and durability of its antidepressant effects over longer periods remain unclear. To our knowledge, this is the first systematic review...
Journal of Intensive Care Medicine
April 16, 2026
Vrutti Patel, Saurabh Sujanyal, Lekhya Raavi et al.
BackgroundKetamine has demonstrated efficacy in treatment-resistant depression, primarily in psychiatric or outpatient populations. Its use in ICU patients remains underexplored, with limited data beyond case reports and small series. This study evaluated the association between subanesthetic ketamine infusions and improvement in depressive symptoms and hemodynamic changes in ICU...
Pharmaceuticals
April 16, 2026
Maria Marmureanu, Mariana Valy Besoiu, Vlad Dionisie et al.
Background/Objective: A substantial proportion of patients with obsessive-compulsive disorder (OCD) does not respond adequately to first-line treatments such as selective serotonin reuptake inhibitors and cognitive-behavioral therapy. OCD has traditionally been conceptualized as a serotonergic disorder. However, emerging evidence suggests that glutamatergic dysfunction plays an important role....
BMC Anesthesiology
April 15, 2026
Wei Tan, Yuanyuan Gao, Dan Su et al.
Depressive symptoms frequently afflict individuals with Parkinson’s disease (PD). The current study was consequently conducted to determine the efficacy of low-dose intravenous esketamine in managing postoperative depressive symptoms, thereby exploring its potential mechanisms of action in PD patients subjected to non-intracranial surgery. In this randomized, double-blind, placebo-controlled...
Journal of Affective Disorders
April 15, 2026
Gia Han Le, Sabrina Wong, Danica E. Johnson et al.
4 citations
Ketamine and esketamine exhibit rapid antidepressant effects in persons with treatment-resistant depression (TRD) and bipolar depression (TRBD). However, the synaptic mechanisms governing dose, frequency, and durability of response remain unclear. This review aims to evaluate the dosing parameters, including minimum dose and optimal dosing intervals, that reliably induce or maintain long-term...
Journal of Affective Disorders
April 15, 2026
Jen-Ping Chen, Chih-Wei Hsu, Yi-Ting Chen et al.
Repetitive transcranial magnetic stimulation (rTMS) and esketamine are FDA-approved treatments for treatment-resistant depression (TRD), yet head-to-head comparative effectiveness data remain limited. Our study compared the effectiveness and safety profiles of rTMS versus esketamine in adults with TRD. This cohort study used target trial emulation with 1:1 propensity score matching on 50...
Molecular Psychiatry
April 13, 2026
Xin Zhao, Xinyu Zhang, Shiying Yuan et al.
Ketamine, a potent N-methyl-D-aspartate receptor (NMDAR) antagonist, is widely used for anesthesia and analgesia and, because of its rapid antidepressant effects, in psychiatry. Increasing evidence suggests that ketamine and its enantiomers-(R)-ketamine (arketamine) and (S)-ketamine (esketamine)-also modulate systemic immunity and provide organ protection, partly through interactions with the...