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Ketamine and treatment resistant depression

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https://www.readbyqxmd.com/read/28922961/effect-of-ketamine-dose-on-self-rated-dissociation-in-patients-with-treatment-refractory-anxiety-disorders
#1
Cameron Castle, Andrew Gray, Shona Neehoff, Paul Glue
Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety...
August 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28922734/persistent-antidepressant-effect-of-low-dose-ketamine-and-activation-in-the-supplementary-motor-area-and-anterior-cingulate-cortex-in-treatment-resistant-depression-a-randomized-control-study
#2
Mu-Hong Chen, Cheng-Ta Li, Wei-Chen Lin, Chen-Jee Hong, Pei-Chi Tu, Ya-Mei Bai, Chih-Ming Cheng, Tung-Ping Su
A single low-dose ketamine infusion exhibited a rapid antidepressant effect within 1h. Despite its short biological half-life (approximately 3h), the antidepressant effect of ketamine has been demonstrated to persist for several days. However, changes in brain function responsible for the persistent antidepressant effect of a single low-dose ketamine infusion remain unclear METHODS: Twenty-four patients with treatment-resistant depression (TRD) were randomized into three groups according to the treatment received: 0...
September 9, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28838328/backing-into-the-future-pharmacological-approaches-to-the-management-of-resistant-depression
#3
P J Cowen
Pragmatic studies indicate that a substantial number of depressed patients do not remit with current first-line antidepressant treatments and after two failed treatment steps the chance of remission with subsequent therapies is around 15%. This paper focuses on current evidence for pharmacological treatments in resistant depression as well as possible future developments. For patients who have failed to respond to two antidepressant trials, augmentation with atypical antipsychotic drugs, specifically quetiapine and aripiprazole, has the best evidence for efficacy, though older treatments such as lithium and triiodothyronine still have utility...
August 25, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28834750/synaptic-regulation-of-a-thalamocortical-circuit-controls-depression-related-behavior
#4
Oliver H Miller, Andreas Bruns, Imen Ben Ammar, Thomas Mueggler, Benjamin J Hall
The NMDA receptor (NMDAR) antagonist ketamine elicits a long-lasting antidepressant response in patients with treatment-resistant depression. Understanding how antagonism of NMDARs alters synapse and circuit function is pivotal to developing circuit-based therapies for depression. Using virally induced gene deletion, ex vivo optogenetic-assisted circuit analysis, and in vivo chemogenetics and fMRI, we assessed the role of NMDARs in the medial prefrontal cortex (mPFC) in controlling depression-related behavior in mice...
August 22, 2017: Cell Reports
https://www.readbyqxmd.com/read/28790825/rapid-infusion-of-esketamine-for-unipolar-and-bipolar-depression-a-retrospective-chart-review
#5
Fernanda S Correia-Melo, Felipe C Argolo, Lucas Araújo-de-Freitas, Gustavo Carneiro Leal, Flávio Kapczinski, Acioly Luiz Lacerda, Lucas C Quarantini
BACKGROUND: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression. METHODS: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28758582/potential-novel-treatments-for-bipolar-depression-ketamine-fatty-acids-anti-inflammatory-agents-and-probiotics
#6
G H Vázquez, S Camino, L Tondo, Ross J Baldessarini
BACKGROUND: Treatments for depression in bipolar disorder (BD) are far less well developed than for unipolar major depressive disorder. Several innovative and experimental approaches have been emerging recently, including use of the dissociative anesthetic ketamine and other antagonists of central NMDA glutamate receptors, as well as unsaturated fatty acids, anti-inflammatory agents, and possibly probiotic methods. METHODS: We reviewed relevant reports from the past decade...
July 28, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28739263/pilot-randomized-controlled-trial-of-titrated-subcutaneous-ketamine-in-older-patients-with-treatment-resistant-depression
#7
Duncan George, Verònica Gálvez, Donel Martin, Divya Kumar, John Leyden, Dusan Hadzi-Pavlovic, Simon Harper, Henry Brodaty, Paul Glue, Rohan Taylor, Philip B Mitchell, Colleen K Loo
OBJECTIVE: To assess the efficacy and safety of subcutaneous ketamine for geriatric treatment-resistant depression. Secondary aims were to examine if repeated treatments were safe and more effective in inducing or prolonging remission than a single treatment. METHODS: In this double-blind, controlled, multiple-crossover study with a 6-month follow-up (randomized controlled trial [RCT] phase), 16 participants (≥60 years) with treatment-resistant depression who relapsed after remission or did not remit in the RCT were administered an open-label phase...
June 13, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28731926/history-of-anaesthesia-the-ketamine-story-past-present-and-future
#8
Georges Mion
No abstract text is available yet for this article.
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28666206/low-dose-ketamine-for-treatment-resistant-depression-in-an-academic-clinical-practice-setting
#9
David Feifel, Benjamin Malcolm, Danielle Boggie, Kelly Lee
BACKGROUND: Recent studies demonstrating a rapid, robust improvement in treatment resistant depression (TRD) following a single sub-anesthetic infusion of ketamine have generated much excitement. However, these studies are limited in their generalizability to the broader TRD population due to their subject exclusion criteria which typically limit psychiatric comorbidity, concurrent medication, and level of suicide risk. This paper describes the safety and efficacy of sub-anesthetic ketamine infusions in a naturalistic TRD patient sample participating in a real-world TRD treatment program within a major university health system...
October 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28649673/rapid-acting-antidepressants-in-chronic-stress-models-molecular-and-cellular-mechanisms
#10
Brendan D Hare, Sriparna Ghosal, Ronald S Duman
Stress-associated disorders, including depression and anxiety, impact nearly 20% of individuals in the United States. The social, health, and economic burden imposed by stress-associated disorders requires in depth research efforts to identify suitable treatment strategies. Traditional medications (e.g., selective serotonin reuptake inhibitors, monoamine oxidase inhibitors) have significant limitations, notably a time lag for therapeutic response that is compounded by low rates of efficacy. Excitement over ketamine, a rapid acting antidepressant effective in treatment resistant patients, is tempered by transient dissociative and psychotomimetic effects, as well as abuse potential...
February 2017: Chronic stress
https://www.readbyqxmd.com/read/28635347/ketamine-and-international-regulations
#11
Yanhui Liao, Yi-Lang Tang, Wei Hao
BACKGROUND: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. OBJECTIVES: To review the nonmedical use of ketamine in selected countries and its regulatory control. METHODS: We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979-2016) and PubMed databases, supplemented by additional references identified by the authors...
September 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28555075/acute-ketamine-administration-corrects-abnormal-inflammatory-bone-markers-in-major-depressive-disorder
#12
B Kadriu, P W Gold, D A Luckenbaugh, M S Lener, E D Ballard, M J Niciu, I D Henter, L T Park, R T De Sousa, P Yuan, R Machado-Vieira, C A Zarate
Patients with major depressive disorder (MDD) have clinically relevant, significant decreases in bone mineral density (BMD). We sought to determine if predictive markers of bone inflammation-the osteoprotegerin (OPG)-RANK-RANKL system or osteopontin (OPN)-play a role in the bone abnormalities associated with MDD and, if so, whether ketamine treatment corrected the abnormalities. The OPG-RANK-RANKL system plays the principal role in determining the balance between bone resorption and bone formation. RANKL is the osteoclast differentiating factor and diminishes BMD...
May 30, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28540033/use-of-repeated-intravenous-ketamine-therapy-in-treatment-resistant-bipolar-depression-with-suicidal-behaviour-a-case-report-from-spain
#13
REVIEW
Álvaro López-Díaz, José Luis Fernández-González, José Evaristo Luján-Jiménez, Sara Galiano-Rus, Luis Gutiérrez-Rojas
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour...
April 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28520578/robust-antidepressant-effect-following-alternating-intravenous-racemic-ketamine-and-electroconvulsive-therapy-in-treatment-resistant-depression-a-case-report
#14
Lucie Bartova, Ana Weidenauer, Markus Dold, Angela Naderi-Heiden, Siegfried Kasper, Matthaeus Willeit, Nicole Praschak-Rieder
No abstract text is available yet for this article.
September 2017: Journal of ECT
https://www.readbyqxmd.com/read/28514237/oral-ketamine-in-treatment-resistant-depression-a-clinical-effectiveness-case-series
#15
Maryam I Al Shirawi, Sidney H Kennedy, Keith T Ho, Roisin Byrne, Jonathan Downar
PURPOSE: The aim of the study was to assess the effectiveness, tolerability, and safety of oral ketamine as an antidepressant treatment in adults with treatment-resistant depression. METHODS: We reviewed retrospective data on 22 patients with treatment-resistant depression, who failed at least 3 adequate antidepressant treatment trials and 1 adequate trial of repetitive transcranial magnetic stimulation; subsequently, they received open-label treatment with oral ketamine, commenced at a dose of 50 mg every 3 days, titrated up by 25 mg every 3 days, according to response and tolerability...
August 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28492279/dose-related-effects-of-adjunctive-ketamine-in-taiwanese-patients-with-treatment-resistant-depression
#16
Tung-Ping Su, Mu-Hong Chen, Cheng-Ta Li, Wei-Chen Lin, Chen-Jee Hong, Ralitza Gueorguieva, Pei-Chi Tu, Ya-Mei Bai, Chih-Ming Cheng, John H Krystal
The antidepressant effects of ketamine are thought to depend on brain-derived neurotrophic factor (BDNF) genotype and dose. The purpose of this study was to characterize the dose-related antidepressant effects of ketamine in patients with treatment-resistant depression drawn from a Chinese population predominately possessing lower activity BDNF genotypes (Val/Met, Met/Met). We conducted a double-blind, randomized, parallel-group, placebo-controlled trial of a single ketamine infusion (saline, 0.2 mg/kg, 0...
May 11, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28490030/cognitive-behavior-therapy-may-sustain-antidepressant-effects-of-intravenous-ketamine-in-treatment-resistant-depression
#17
Samuel T Wilkinson, DaShaun Wright, Madonna K Fasula, Lisa Fenton, Matthew Griepp, Robert B Ostroff, Gerard Sanacora
INTRODUCTION: Ketamine has shown rapid though short-lived antidepressant effects. The possibility of concerning neurobiological changes following repeated exposure to the drug motivates the development of strategies that obviate or minimize the need for longer-term treatment with ketamine. In this open-label trial, we investigated whether cognitive behavioral therapy (CBT) can sustain or extend ketamine's antidepressant effects. METHODS: Patients who were pursuing ketamine infusion therapy for treatment-resistant depression were invited to participate in the study...
2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/28441895/ketamine-s-dose-related-effects-on-anxiety-symptoms-in-patients-with-treatment-refractory-anxiety-disorders
#18
Paul Glue, Natalie J Medlicott, Sarah Harland, Shona Neehoff, Bridie Anderson-Fahey, Martin Le Nedelec, Andrew Gray, Neil McNaughton
The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0...
April 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#19
Maxim Zavorotnyy, Ina Kluge, Kathrin Ahrens, Thomas Wohltmann, Benjamin Köhnlein, Patricia Dietsche, Udo Dannlowski, Tilo Kircher, Carsten Konrad
Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0...
April 19, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28418641/classics-in-chemical-neuroscience-ketamine
#20
Marshall W Tyler, Harmony B Yourish, Dawn F Ionescu, Stephen J Haggarty
Ketamine, a molecule of many faces, has contributed immeasurably to numerous realms of clinical practice and scientific inquiry. From anesthesia and analgesia to depression and schizophrenia, it continues to shed light on the molecular underpinnings of pain, consciousness, and the pathophysiology of neuropsychiatric disorders. In particular, research on ketamine's mechanism of action is providing new hope in the search for therapies for treatment-resistant depression and affords insights into disorders of glutamatergic dysfunction...
June 21, 2017: ACS Chemical Neuroscience
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