Treatment-resistant depression (TRD) and bipolar depression (TRBD) are severe, heterogeneous mood disorders associated with substantial functional impairment, elevated suicide risk and persistent unmet treatment needs. While pharmacological and psychological interventions continue to advance, many patients experience delayed, partial or unsustained benefit, underscoring the need for therapies...
Ketamine has emerged as a promising rapid-acting antidepressant for treatment-resistant depression (TRD), yet its mechanisms of action and reliable biomarkers of treatment response remain poorly understood. Recent evidence suggests that the aperiodic exponent (1/f slope) of electroencephalography (EEG) power spectra reflects cortical excitation-inhibition balance (EIB), offering a potential...
Figshare2026Daniel Pustay, Vishal Patel, Krista Ulisse et al.
preprint
Treatment-resistant depression (TRD) remains a complex challenge, often requiring interventions beyond standard medications. This review explores factors that may predict positive response to electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS) and ketamine-based treatments to help guide clinical decision-making. A systematic review was conducted following PRISMA...
The reported mixed findings suggest that the opioid system may exert a partial mediating effect of ketamine in TRD. However, given the inconsistent attenuation of ketamine's antidepressant effects by opioid receptor antagonists, the opioid system likely functions as a context-dependent modulator rather than a primary mediator, particularly at standard antidepressant doses.
This preregistration documents an update and extension of a meta-analysis of ketamine and esketamine for adults with treatment-resistant major depressive disorder (TRD). The project is nested within an existing network meta-analysis for TRD (NMA-TRD) project, which has already been fully specified and registered: • Muit et al., BMJ Open 2022 – protocol for a systematic review and network...
Brain and Behavior2026Filipa Alves Da Silva, Rita Avelar, Bernardo Peixoto et al.
Depression affects around 280 million people worldwide, and about 30% of patients have treatment-resistant depression. Ketamine has significant scientific evidence supporting its use as an antidepressant, making it a promising approach for treatment-resistant cases. Combining ketamine with psychotherapy may enhance therapeutic response and support longer-lasting cognitive and behavioral change....
Glenohumeral dislocation is the most common type of shoulder dislocation and a leading cause of shoulder instability. Adequate muscle relaxation and pain control are essential for successful reduction. This study compared the effectiveness and safety of ketamine-midazolam (KM) versus ketamine-propofol (KP) for procedural sedation in anterior shoulder dislocations in the emergency department...
Chronic ketamine abuse is a well-recognized cause of lower urinary tract injury. Hepatobiliary manifestations are less frequently reported. A case is presented of concomitant ketamine-induced uropathy and cholangiopathy in a young adult. This underscores the importance of considering ketamine toxicity as a multisystem disorder. Teaching point: Beyond the well-recognized urinary tract...
The efficacy of standard 5-fluorouracil (5-FU) chemotherapy for colorectal cancer is limited by drug resistance and adverse effects, prompting research into esketamine, a potent ketamine variant with analgesic, antidepressant, and recently discovered anti-tumor properties, to determine if it can enhance 5-FU's chemosensitivity. This study investigates whether esketamine synergizes with 5-FU to...
Anhedonia is a key symptom of bipolar depression and a target of ketamine's rapid antidepressant effects. However, many patients with treatment-resistant bipolar depression (TRBD) do not respond. This study aimed to identify clinical and sociodemographic characteristics that are associated with nonresponse of anhedonia following short-term ketamine treatment in TRBD. A retrospective analysis...