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Ketamine and treatment resistant depression

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https://www.readbyqxmd.com/read/28635347/ketamine-and-international-regulations
#1
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...
February 13, 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
#2
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
#3
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
#4
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.
May 18, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28514237/oral-ketamine-in-treatment-resistant-depression-a-clinical-effectiveness-case-series
#5
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...
May 17, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28492279/dose-related-effects-of-adjunctive-ketamine-in-taiwanese-patients-with-treatment-resistant-depression
#6
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 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, 0.5 mg/kg). Patients (N=71; BDNF genotype: Val/Val (N=12, 17%), Val/Met (N=40, 56...
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28413097/mglu2-3-receptor-antagonists-as-novel-antidepressants
#11
REVIEW
Shigeyuki Chaki
Based on the discovery of the robust antidepressant effects of ketamine in patients with depression, including those with treatment-resistant depression, agents acting on the glutamatergic system have drawn much attention as potential novel antidepressants. Among the agents acting on the glutamatergic system, preclinical data have indicated that the group II metabotropic glutamate (mGlu) receptors, mGlu2 and mGlu3, are attractive targets for the development of novel antidepressants. The antidepressant effects of mGlu2/3 receptor antagonists have been demonstrated in rodent models, and the synaptic and neural mechanisms underlying the antidepressant effects of these compounds have been investigated...
April 13, 2017: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/28395988/ketamine-treatment-for-depression-opportunities-for-clinical-innovation-and-ethical-foresight
#12
REVIEW
Ilina Singh, Celia Morgan, Valerie Curran, David Nutt, Anne Schlag, Rupert McShane
We present a review and analysis of the ethical considerations in off-label ketamine use for severe, treatment-resistant depression. The analysis of ethical considerations is contextualised in an overview of the evidence for ketamine use in depression, and a review of the drug's safety profile. We find that, based on current evidence, ketamine use for severe, treatment-resistant depression does not violate ethical principles; however, clinicians and professional bodies must take steps to ensure that guidelines for good practice are enacted, that all experimental and trial data are made available through national registries, and that the risk potential of ketamine treatment continues to be monitored and modelled...
May 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28386522/ketamine-therapy-for-treatment-resistant-depression-in-a-patient-with-multiple-sclerosis-a-case-report
#13
Michael M Messer, Irina V Haller
Objective: Depression is a common condition among patients with multiple sclerosis and often becomes resistant to oral antidepressants. We report a patient with multiple sclerosis who developed severe treatment-resistant depression and who was successfully treated with intravenous ketamine over the period of two years. Methods: Ketamine treatment protocol included an initial series of six treatments administered every other day, followed by a maintenance schedule. Ketamine was administered intravenously at 0...
January 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28323284/altered-peripheral-immune-profiles-in-treatment-resistant-depression-response-to-ketamine-and-prediction-of-treatment-outcome
#14
D D Kiraly, S R Horn, N T Van Dam, S Costi, J Schwartz, S Kim-Schulze, M Patel, G E Hodes, S J Russo, M Merad, D V Iosifescu, D S Charney, J W Murrough
A subset of patients with depression have elevated levels of inflammatory cytokines, and some studies demonstrate interaction between inflammatory factors and treatment outcome. However, most studies focus on only a narrow subset of factors in a patient sample. In the current study, we analyzed broad immune profiles in blood from patients with treatment-resistant depression (TRD) at baseline and following treatment with the glutamate modulator ketamine. Serum was analyzed from 26 healthy control and 33 actively depressed TRD patients free of antidepressant medication, and matched for age, sex and body mass index...
March 21, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28294051/further-evaluation-of-mechanisms-associated-with-the-antidepressant-like-signature-of-scopolamine-in-mice
#15
Anna E Martin, Douglas A Schober, Alexander Nikolayev, Vladimir V Tolstikov, Wesley H Anderson, Richard E Higgs, Ming-Shang Kuo, Anastasia Laksmanan, John T Catlow, Xia Li, Christian C Felder, Jeffrey M Witkin
Conventional antidepressants lack efficacy for many patients (treatment-resistant depression or TRD) and generally take weeks to produce full therapeutic response in others. Emerging data has identified certain drugs such as ketamine as rapidly-acting antidepressants for major depressive disorder and TRD. Scopolamine, a drug used to treat motion sickness and nausea, has also been demonstrated to function as a rapidly-acting antidepressant. The mechanisms associated with efficacy in TRD patients and rapid onset of action have been suggested to involve a-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor and mammalian target of rapamycin (mTOR) signaling...
March 9, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28271731/ketamine-augmentation-rapidly-improves-depression-scores-in-inpatients-with-treatment-resistant-bipolar-depression
#16
Janusz K Rybakowski, Agnieszka Permoda-Osip, Alicja Bartkowska-Sniatkowska
OBJECTIVE: To study the clinical effect of a single ketamine infusion, 0.5 mg/kg body weight, in bipolar depressive patients receiving mood-stabilising drugs, not improving on antidepressants. Previously, in such patients, we had found a correlation between clinical efficacy, serum brain-derived neurotrophic factor and vitamin B12 levels and a rapid improvement in neurocognitive performance. METHODS: The study included 53 patients (13 men, 40 women), aged 22-81 years, receiving ≥1 mood-stabilising medications of the first and/or second generation...
March 8, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28257514/analysis-of-print-news-media-framing-of-ketamine-treatment-in-the-united-states-and-canada-from-2000-to-2015
#17
Melvyn W B Zhang, Ying X Hong, Syeda F Husain, Keith M Harris, Roger C M Ho
OBJECTIVES: There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time. METHODS: Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers...
2017: PloS One
https://www.readbyqxmd.com/read/28250331/elucidation-of-the-role-of-dorsal-raphe-serotonergic-neurons-in-mood-regulation-using-pharmacological-and-viral-vector-based-approaches
#18
REVIEW
Kazuki Nagayasu
 Growing evidence indicates that serotonergic neurons play a crucial role in brain function and dysfunction, such as in major depressive disorder. However, the complexity of serotonergic projections severely hampers the elucidation of their precise mechanisms. Here we summarize our recent studies on the effects of ketamine and olanzapine, which have been reported to be effective in treatment-resistant depression, on dorsal raphe nucleus serotonergic neurons, using microdialysis, electrophysiology experiments, and slice cultures...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28228087/beyond-ketamine-new-approaches-to-the-development-of-safer-antidepressants
#19
Shigeyuki Chaki
Ketamine has been reported to exert rapid and sustained antidepressant effects in patients with depression, including patients with treatment-resistant depression. However, ketamine has several drawbacks such as psychotomimetic/dissociative symptoms, abuse potential and neurotoxicity, all of which prevent its routine use in daily clinical practice. Therefore, development of novel agents with fewer safety and usage concerns for the treatment of depression has been actively investigated. From this standpoint, searching for active substances (stereoisomers and metabolites) and agents acting on the N-methyl-D-aspartate (NMDA) receptor have recently gained much attention...
February 20, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28222822/electroconvulsive-therapy-with-s-ketamine-anesthesia-for-catatonia-in-coexisting-depression-and-dementia
#20
Zsuzsa Litvan, Martin Bauer, Siegfried Kasper, Richard Frey
Information on efficacy and safety of electroconvulsive therapy in patients with dementia is sparse. The current case report describes a patient suffering from severe depression and dementia who received electroconvulsive therapy with S-ketamine anesthesia at our psychiatric intensive care unit for the treatment of her therapy-resistant catatonic stupor. The patient's condition improved remarkably through the treatment. By the end of 16 electroconvulsive therapy sessions, her catatonic symptoms remitted entirely, her affect was brighter and she performed markedly better at the cognitive testing...
February 22, 2017: International Psychogeriatrics
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