Ketamine, a dissociative anaesthetic, has expanded its clinical use beyond anaesthesia to pain management and treatment-resistant depression. As an N-methyl-d-aspartate receptor antagonist, ketamine disrupts the excitatory neurotransmission via interaction with the opioid, alpha-amino-3-hydroxy-5-methyl-4-isooxazole-propionic acid receptor and serotonin pathways, contributing to its broad...
Abnormalities during rapid eye movement (REM) sleep contribute to the pathophysiology of major depressive disorder (MDD), but few studies have explored the relationship between REM sleep and treatment-resistant depression (TRD). In MDD, REM sleep abnormalities often manifest as alterations in total night REM Density (RD), RD in the first REM period (RD1), and REM Latency (RL). Among these, RD1...
The drug development process in psychiatry faces significant challenges due to low reproducibility rates in animal testing, which often leads to translation failures. To address this issue, we introduce a new approach in psychiatric drug development: a preclinical randomized controlled trial (preRCT). To demonstrate its potential utility, we conducted a multi-center preRCT using the alcohol...
Previous studies have shown patient preference can have large effects on treatment adherence and patient satisfaction. However, the direct effects of matching treatment with patient preference on efficacy and safety outcomes remain unclear. We aimed to evaluate the effects of patient preference and preference-matching on efficacy, adverse events, and adherence to electroconvulsive therapy (ECT)...
The pharmacologically active (R,S)-ketamine (ketamine) metabolite (2 R,6 R)-hydroxynorketamine (HNK) maintains ketamine's preclinical antidepressant profile without adverse effects. While hypotheses have been proposed to explain how ketamine and its metabolites initiate their antidepressant-relevant effects, it remains unclear how sustained therapeutic actions arise following drug elimination....
Emerging viral pathogens, newly reported or rapidly evolving viruses, are a significant public health concern worldwide. Beyond their characteristic clinical presentations, emerging viruses, such as monkeypox virus (MPXV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been increasingly implicated in the development of various neuropsychiatric complications including...
Ketamine, a dissociative anesthetic with well documented abuse liability, can also provide rapid-onset and persistent antidepressant effects and is currently used for the management of treatment-resistant depression. Although the precise neurobiological mechanisms underlying its antidepressant actions are not fully determined, a critical feature of ketamine's clinical efficacy may be its...
Rapid sequence induction (RSI) is a potentially-life saving intervention in critically ill patients. An important adverse effect of this procedure is post-induction hypotension (PIH), which is associated with worsened patient outcomes. Choice of induction agent can affect incidence of PIH, although the optimal drug has yet to be determined. Ketamine is postulated to reduce PIH incidence in...
Substance Use & MisuseMay 1, 2025Corinne L Chandler, Mance E Buttram, Matthew S Ellis1 citation
Data show that recreational ketamine use appears to be increasing. This study aimed to understand how ketamine fits into broader polysubstance use in individuals with opioid use disorder (OUD). Survey data were collected from a sample of treatment-seeking individuals with OUD in March 2022. Of 301 respondents, 28.6% reported lifetime ketamine use. Ketamine use was more frequently reported among...
Ketamine, a dissociative anesthetic, has gained widespread use in various medical contexts, including anesthesia, pain management, and treatment-resistant depression. Despite its therapeutic potential, concerns regarding its safety profile have prompted ongoing research and regulatory guidance. This comprehensive literature review explores the current safety considerations of ketamine,...