Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, was approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive processes,...
Despite the availability of many treatment options, several individuals with bipolar disorders experience persistent symptoms, necessitating the exploration of novel therapeutic approaches. In recent years, there has been a growing interest in repurposing drugs of abuse, such as stimulants, ketamine, and psychedelics, for the treatment of bipolar disorders. While some of these drugs have...
Depression is a debilitating psychiatric disorder. Electroconvulsive therapy (ECT) and ketamine are effective treatments for severe depression, but target populations may differ. Systematic reviews on the few available trials show higher remission rates with ECT than with ketamine. Nonetheless, ketamine’s rapid onset of action is comparable to ECT but with less cognitive adverse effects. This...
Substance use disorders (SUDs), including alcohol, opioid, and cocaine dependencies, present significant challenges in public health. Current treatment modalities often face limitations in efficacy and accessibility, necessitating exploration of novel therapeutic approaches. Ketamine, originally recognized for its anesthetic properties, has garnered attention for its potential in treating SUDs...
Ketamine2025Jose Eduardo Guimaraes Pereira, Carlos Darcy Alves Bersot, Thiago Ramos Grigio et al.1 citation
Neuropathic pain (NP) is a frequently undertreated component of chronic pain, posing challenges due to its complexity. This has led to interest in N-methyl-D-aspartate receptor (NMDAR) antagonists like ketamine. NP is linked to maladaptive processes, such as NMDAR-related windup and sensitization. While results from ketamine trials on chronic NP have been inconsistent, perioperative use has...
Although both intranasal esketamine and intravenous ketamine have proven efficacy and tolerability in treatment-resistant depression (TRD), patient access to these treatments is often limited due to cost, availability, and/or monitoring requirements. This article is intended to provide a synthesis of the current literature with regard to the pharmacologic use of ketamine in TRD and describe its...
Ketamine produces fast-acting antidepressant effects in treatment-resistant depression (TRD). Prior studies have shown altered functional dynamics between brain networks in major depression. We thus sought to determine whether functional brain network dynamics are modulated by ketamine therapy in TRD. Participants with TRD (n = 58, mean age = 40.7 years, female = 48.3%) completed resting-state...
Chronic pain is an individual experience with physical and psychological dimensions. Ketamine is used in sub-anesthetic doses to treat chronic pain. We describe a proposed multidisciplinary approach with combined treatment of low-dose ketamine and pain-focused psychological and somatic therapies to benefit quality of life of disabled chronic pain patients. Beyond pain reduction, within the...
Ketamine and esketamine have demonstrated rapid, short-term antidepressant effects in major depressive disorder (MDD), but their relative safety remains unclear. This review aims to update the evidence on the safety of two agents for MDD and indirectly compare their safety and tolerability. We systematically searched PubMed, PsycINFO, Embase, and Cochrane databases up to 1 May 2025. Eligible...
Ketamine's antidepressant effects have been linked to its modulation of glutamatergic neurotransmission and synaptic plasticity. However, the precise roles of both glutamate (Glu) levels and brain-derived neurotrophic factor (BDNF) in this process remain incompletely understood. This study examined the relationship between ketamine-induced changes in Glu levels and peripheral BDNF levels using...