Ketamine may have antidepressant and anti-suicidal effects. However, the mechanism underlying ketamine-mediated improvement in cognitive impairment in patients with depression remains unclear. To improve patient cognition in depression using molecular docking and network pharmacology, we examined ketamine's key targets and identified its molecular mechanisms. To gain target information about...
Understanding the physiological changes induced by ketamine in mood disorders, while reducing its side effects, is likely to contribute to a more comprehensive understanding of the physiology underlying mood disorders, as well as to the development of faster-acting and more efficacious antidepressant treatments. An extensive review of the literature on ketamine and the pathophysiology of...
Background: Major depressive disorder (MDD) is highly prevalent and associated with significant disability and mortality. Treatment-resistant depression (TRD), defined as inadequate response to ⩾2 antidepressant lines, remains a major therapeutic challenge. Esketamine nasal spray, approved in 2019 for TRD, demonstrated efficacy and safety in randomized trials, but real-world evidence remains...
Dreaming during anaesthesia has been documented for over a century, yet it remains poorly understood. This scoping review synthesises evidence on the frequency, phenomenology, predictors, outcomes, and neural correlates of anaesthesia dreaming. We systematically searched multiple databases for studies examining anaesthesia dreaming, including clinical trials, observational studies, and...
Trigeminal neuralgia (TN) is a debilitating orofacial pain condition frequently complicated by anxiety and depression, forming a self-reinforcing pain-affect cycle with limited therapeutic options. A TN mouse model with anxiety-like behavior was established using partial infraorbital nerve transection (pIONT). Esketamine (ES) (5 or 10 mg/kg) was administered intraperitoneally from postoperative...
This study evaluated the long-term comparative effectiveness and safety of esketamine versus injectable ketamine and esketamine versus oral antidepressants for major depressive disorder (MDD). This emulated target trial utilized observational data from a cohort of U.S. adults with MDD between 2018 and 2024. Patients were categorized into those receiving esketamine, injectable R,S-ketamine, and...
Ketamine and esketamine have been increasingly used as adjunctive treatments for treatment-resistant depression (TRD), yet evidence on pharmacological interactions with commonly prescribed psychotropic medications remains limited. This study evaluated the association between concomitant lamotrigine, lithium, and benzodiazepine use and antidepressant outcomes during subcutaneous esketamine...
Patients with serious illnesses and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. In this Palliative Care Rounds, we examine the evidence for ketamine/esketamine's efficacy as antidepressants, including evidence specific to people with serious illnesses. In psychiatric...
Intravenous ketamine has emerged as a rapid-acting antidepressant intervention that has shown promising effects in patients with treatment-resistant depression, although evidence remains heterogeneous and less well established across diagnostic subtypes. Nevertheless, real-world data comparing diagnostic subtypes and sex-related differences remain limited. This observational study examined the...
Depression and existential distress are highly prevalent among patients with advanced cancer, and there is growing evidence for ketamine as a rapidly acting antidepressant in the population, but few studies have examined existential distress outcomes with ketamine treatment. The INKeD-PC trial demonstrated efficacy of intranasal racemic ketamine for depression in patients with cancer receiving...
Ketamine may alleviate treatment-resistant depression (TRD) primarily through glutamatergic modulation, with downstream dopaminergic activation. Iron plays an important role in monoaminergic metabolism, that is also implicated in the pathophysiology of TRD. Both Quantitative Susceptibility Mapping (QSM) and Effective Transverse Relaxation Rate (R2*) mapping can determine the extent of iron...
Animals must balance reward seeking against potential danger, and impairments in such conflict decision-making are common in psychiatric disorders. Here, we examined how chronic corticosterone exposure and ketamine affect conflict behavior in mice by presenting them with a three-compartment conflict task. Three weeks of corticosterone increased conflict levels without inducing anhedonia,...
BACKGROUND: Major depressive disorder (MDD) is one of the leading causes of disability globally, and conventional monoaminergic antidepressants often have a slow onset and limited efficacy. About onethird of patients suffer from treatment-resistant depression (TRD), which emphasizes the urgent need for alternative therapies. This review aims to systematically evaluate the available data about...
Objectives: This article reviews the clinical status and treatment challenges of cancer-related depressive states, clarifies the mechanism of action of esketamine-a novel rapid-acting antidepressant-compares its efficacy with traditional drugs, evaluates safety and tolerability, and summarizes clinical evidence to support clinical practice and research. Methods: By searching databases such as...
This is a case report of a 52 year old female with ECT-refractory bipolar depression who was treated with esketamine nasal spray, leading to a noticeable improvement in her depressive symptoms. She experienced a relapse after a reduction in her maintenance treatment in conjunction with psychosocial stressors, but improved once again after returning to her induction regimen. She tolerated the...
Background Depression remains a leading cause of disability and suicide worldwide, with treatment-resistant depression (TRD) affecting nearly 30% of individuals diagnosed with major depressive disorder. Esketamine nasal spray (NS) and quetiapine extended-release (XR) are both approved as adjunctive therapies for TRD; however, direct head-to-head comparisons are limited. Method A systematic...
Adolescents frequently seek care in the emergency department (ED) for behavioral health emergencies. Due to national shortages in staffing, limited opportunities to begin treatment on site in most centers and, thus, the frequent default to elusive inpatient psychiatric beds as a means of stabilization, adolescents may spend prolonged amounts of time boarding in the ED, often without treatment....
Treatment-resistant depression (TRD) is a heterogeneous condition in which symptoms such as anhedonia, rumination, and anxiety contribute to persistent disability. Esketamine nasal spray (ESK-NS), accelerated repetitive transcranial magnetic stimulation (arTMS), and adjunctive brexpiprazole represent novel therapeutic options with distinct mechanisms, though their domain-specific effects in...