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Ketamine and treatment resistant depression

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https://www.readbyqxmd.com/read/29750979/ketamine-facilitates-extinction-of-avoidance-behavior-and-enhances-synaptic-plasticity-in-a-rat-model-of-anxiety-vulnerability-implications-for-the-pathophysiology-and-treatment-of-anxiety-disorders
#1
Ashley M Fortress, Ian M Smith, Kevin C H Pang
Anxiety disorders and posttraumatic stress disorder (PTSD) share a common feature of pathological avoidance behavior. The Wistar Kyoto (WKY) rat has been used as a model of anxiety vulnerability, expressing a behaviorally inhibited temperament, acquiring avoidance behavior more rapidly and displaying extinction-resistant avoidance compared to Sprague Dawley (SD) rats. Subanesthetic levels of ketamine have gained attention as a rapid antidepressant in treatment-resistant depression. While traditional antidepressants are commonly used to treat anxiety disorders and PTSD, the therapeutic utility of ketamine for these disorders is much less understood...
May 8, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29736744/antidepressant-efficacy-and-tolerability-of-ketamine-and-esketamine-a-critical-review
#2
REVIEW
P Molero, J A Ramos-Quiroga, R Martin-Santos, E Calvo-Sánchez, L Gutiérrez-Rojas, J J Meana
Ketamine and its enantiomer S-ketamine (esketamine) are promising candidates to produce a rapid-onset antidepressant effect in treatment-resistant depression. Ketamine causes continued blockade of the glutamate N-methyl-D-aspartate (NMDA) receptor, though this might not primarily mediate the antidepressant effect. Alternative hypotheses include selectivity for the NMDA receptor subtype containing the NMDA receptor subunit 2B (NR2B), inhibition of the phosphorylation of the eukaryotic elongation factor 2 (eEF2) kinase, increased expression of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrKB), and activation of the mammalian target of rapamycin (mTOR) signaling pathway, alongside other independent actions attributed to the ketamine metabolism to R-hydroxynorketamine (R-HNK)...
May 7, 2018: CNS Drugs
https://www.readbyqxmd.com/read/29727073/efficacy-safety-and-durability-of-repeated-ketamine-infusions-for-comorbid-posttraumatic-stress-disorder-and-treatment-resistant-depression
#3
C Sophia Albott, Kelvin O Lim, Miriam K Forbes, Christopher Erbes, Susanna J Tye, John G Grabowski, Paul Thuras, Tegan M Batres-Y-Carr, Joseph Wels, Paulo R Shiroma
OBJECTIVE: The present study examined the efficacy, safety, and durability of repeated ketamine infusions for the treatment of comorbid posttraumatic stress disorder (PTSD) and treatment-resistant depression (TRD) in a sample of veterans. METHODS: Individuals with comorbid DSM-5-defined PTSD and DSM-IV-defined major depressive disorder (N = 15) received 6 intravenous ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period from May 2015 to June 2016...
May 1, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29726758/pharmacotherapy-for-the-treatment-of-depression-in-patients-with-alzheimer-s-disease-a-treatment-resistant-depressive-disorder
#4
Madia Lozupone, Maddalena La Montagna, Francesca D'Urso, Carla Piccininni, Rodolfo Sardone, Vittorio Dibello, Gianluigi Giannelli, Vincenzo Solfrizzi, Antonio Greco, Antonio Daniele, Nicola Quaranta, Davide Seripa, Antonello Bellomo, Giancarlo Logroscino, Francesco Panza
Pharmacotherapy for the treatment of depressive disorders in Alzheimer's Disease (AD) represents a clinical challenge. pharmacological options are often attempted after a period of watchful waiting (8-12 weeks). monoaminergic antidepressant drugs have shown only modest or null clinical benefits, maybe because the etiology of depressive symptoms in ad patients is fundamentally different from that of nondemented subjects. Areas covered: The following article looks at the selective serotonin reuptake inhibitor sertraline, which is one of the most frequently studied antidepressant medications in randomized controlled trials (RCTs)...
May 4, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29722313/ketamine-enhances-structural-plasticity-in-human-dopaminergic-neurons-possible-relevance-for-treatment-resistant-depression
#5
Ginetta Collo, Emilio Merlo Pich
No abstract text is available yet for this article.
April 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29719350/a-case-report-of-a-patient-with-treatment-resistant-depression-successfully-treated-with-repeated-intravenous-injections-of-a-low-dosage-of-ketamine
#6
Shikai Wang, Mincai Qian, Liang Li, Qi Yang
Depression is a highly prevalent and severely disabling disease. The treatment effects, intensity and onset time of antidepressants have been highlighted in many studies. Recent studies on the rapid-onset of antidepressant response focused on the effect of a single low dose of intravenous ketamine. However, there are still some problems with treatment, including safety, efficacy, ethics, dose, frequency of administration and their effect in treatment-resistant depression. In the present study, we treated one case of treatment resistant depression with repeated intravenous injections with a low dosage of ketamine...
December 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/29718262/ketamine-effects-on-eeg-during-therapy-of-treatment-resistant-generalized-anxiety-and-social-anxiety
#7
Shabah Mohammad Shadli, Tame Kawe, Daniel Martin, Neil McNaughton, Shona Neehoff, Paul Glue
Background: Ketamine is swiftly effective in a range of neurotic disorders that are resistant to conventional antidepressant and anxiolytic drugs. The neural basis for its therapeutic action is unknown. Here we report the effects of ketamine on the EEG of patients with treatment-resistant generalized anxiety and social anxiety disorders. Methods: Twelve patients with refractory DSM-IV generalized anxiety disorder and/or social anxiety disorder provided EEG during 10 minutes of relaxation before and 2 hours after receiving double-blind drug administration...
April 24, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29718013/ketamine-for-treatment-resistant-depression-a-new-advocate
#8
Rodrigo Pérez-Esparza
Current alternatives for the treatment of major depressive disorder lack efficacy and have a delayed onset of action. Recently, the glutamatergic neurotransmission system has been noted to play an important role in the pathophysiology of this disorder. Ever since the first report of the antidepressant effects of the N-methyl-D-aspartate receptor antagonist, ketamine, research has been redirected to novel therapeutic targets. With this rapidly growing evidence of a fast-acting antidepressant such as ketamine, as well as its efficacy in treatment-resistant cases of depression, off-label use has become popular in certain settings...
2018: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/29702122/temporally-dissociable-effects-of-ketamine-on-neuronal-discharge-and-gamma-oscillations-in-rat-thalamo-cortical-networks
#9
Maria Amat-Foraster, Anders A Jensen, Niels Plath, Kjartan F Herrik, Pau Celada, Francesc Artigas
BACKGROUND: Sub-anesthetic doses of the non-competitive N-methyl-d-aspartate receptor (NMDA-R) antagonist ketamine evoke transient psychotomimetic effects, followed by persistent antidepressant effects in treatment-resistant depressed patients and rodents through still poorly understood mechanisms. Since phencyclidine (PCP) disinhibits thalamo-cortical networks by blocking NMDA-Rs on GABAergic neurons of the reticular thalamic nucleus (RtN), we examined ketamine's actions in the same areas...
April 24, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29700801/ketamine-based-anesthesia-improves-electroconvulsive-therapy-outcomes-a-randomized-controlled-study
#10
Jonathan J Gamble, Henry Bi, Rudy Bowen, Grahme Weisgerber, Rohan Sanjanwala, Renuka Prasad, Lloyd Balbuena
BACKGROUND: Major depressive disorder (MDD) is a common and debilitating condition that can be challenging to treat. Electroconvulsive therapy (ECT) is currently the therapeutic gold standard for treatment-resistant MDD. We tested our hypothesis that ketamine-based anesthesia for ECT results in superior improvement in treatment-resistant MDD outcomes compared with propofol-based anesthesia. METHODS: Patients with treatment-resistant MDD were enrolled in a randomized clinical trial with assignment to ketamine- or propofol-based anesthesia arms...
February 21, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29699723/delayed-increase-of-thrombocyte-levels-after-a-single-sub-anesthetic-dose-of-ketamine-a-randomized-trial
#11
Lejla Colic, Marie Woelfer, Merima Colic, Anna Linda Leutritz, Thomas Liebe, Luisa Fensky, Zumrut Duygu Sen, Meng Li, Juliane Hoffmann, Moritz A Kretzschmar, Berend Isermann, Martin Walter
Recently, ketamine has been investigated as a potential antidepressant option for treatment resistant depression. Unlike traditional drugs, it yields immediate effects, most likely via increased glutamatergic transmission and synaptic plasticity. However, ketamine administration in humans is systemic and its long-term impact on blood parameters has not yet been described in clinical studies. Here we investigated potential sustained effects of ketamine administration (0.5 mg/kg ketamine racemate) on hematological and biochemical values in plasma and serum in a randomized double-blinded study...
April 23, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29673146/predictors-of-response-to-ketamine-in-treatment-resistant-major-depressive-disorder-and-bipolar-disorder
#12
Carola Rong, Caroline Park, Joshua D Rosenblat, Mehala Subramaniapillai, Hannah Zuckerman, Dominika Fus, Yena L Lee, Zihang Pan, Elisa Brietzke, Rodrigo B Mansur, Danielle S Cha, Leanna M W Lui, Roger S McIntyre
OBJECTIVES: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. METHOD: Electronic search engines PubMed/MEDLINE, ClinicalTrials...
April 17, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29665520/treatment-resistant-depression-and-suicidality
#13
REVIEW
Isidoor O Bergfeld, Mariska Mantione, Martijn Figee, P Richard Schuurman, Anja Lok, Damiaan Denys
BACKGROUND: Thirty percent of patients with treatment-resistant depression (TRD) attempt suicide at least once during their lifetime. However, it is unclear what the attempted and completed suicide incidences are in TRD patients after initiating a treatment, and whether specific treatments increase or decrease these incidences. METHODS: We searched PubMed systematically for studies of depressed patients who failed at least two antidepressant therapies and were followed for at least three months after initiating a treatment...
April 3, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29664276/effects-of-n-n-dimethyltryptamine-dmt-on-rat-behaviors-relevant-to-anxiety-and-depression
#14
Lindsay P Cameron, Charlie J Benson, Lee E Dunlap, David E Olson
Depression and anxiety disorders are debilitating diseases resulting in substantial economic costs to society. Traditional antidepressants often take weeks to months to positively affect mood and are ineffective for about 30% of the population. Alternatives, such as ketamine, a dissociative anesthetic capable of producing hallucinations, and the psychoactive tisane ayahuasca have shown great promise due to their fast-acting nature and effectiveness in treatment-resistant populations. Here, we investigate the effects of N,N-dimethyltryptamine (DMT), the principle hallucinogenic component of ayahuasca, in rodent behavioral assays relevant to anxiety and depression using adult, male, Sprague-Dawley rats...
April 17, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29655977/dexmedetomidine-or-fentanyl-cardiovascular-stability-and-analgesia-during-propofol-ketamine-total-intravenous-anaesthesia-in-experimental-pigs
#15
Andreas Lervik, Joanna Raszplewicz, Birgit Ranheim, Susanna Solbak, Simen F Toverud, Henning A Haga
OBJECTIVE: To compare cardiovascular function and response to nociception during total intravenous anaesthesia in pigs with propofol, ketamine and either dexmedetomidine or fentanyl administered as a continuous infusion. STUDY DESIGN: Blinded, randomized, balanced, crossover study ANIMALS: Eight immunocastrated male, mixed breed pigs with a mean ± standard deviation body weight of 26.4 ± 1.9 kg for dexmedetomidine and 27.5 ± 3.8 kg for fentanyl treatment...
May 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29596148/personalized-n-of-1-trials-for-depression-a-systematic-review
#16
Ian M Kronish, Meghan Hampsey, Louise Falzon, Beatrice Konrad, Karina W Davidson
PURPOSE/BACKGROUND: Personalized (N-of-1) trials are single-patient, crossover-design trials that may be useful for personalizing the selection of depression treatments. We conducted a systematic review of published N-of-1 trials for depression to determine the feasibility and suitability of this methodology for personalizing depression care. METHODS/PROCEDURES: Electronic databases were searched from database inception through October 2016. Studies were selected if they enrolled depressed patients, included a within-subject crossover design, and systematically assessed depressive symptoms during the N-of-1 trial...
June 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29559781/novel-treatment-options-in-depression-and-psychosis
#17
REVIEW
Eva Ceskova, Petr Silhan
In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29542371/repeated-intranasal-ketamine-for-treatment-resistant-depression-the-way-to-go-results-from-a-pilot-randomised-controlled-trial
#18
Verònica Gálvez, Adrienne Li, Christina Huggins, Paul Glue, Donel Martin, Andrew A Somogyi, Angelo Alonzo, Anthony Rodgers, Philip B Mitchell, Colleen K Loo
BACKGROUND: Ketamine research in depression has mostly used intravenous, weight-based approaches, which are difficult to translate clinically. Intranasal (IN) ketamine is a promising alternative but no controlled data has been published on the feasibility, safety and potential efficacy of repeated IN ketamine treatments. METHODS: This randomised, double-blind, placebo-controlled pilot study compared a 4-week course of eight treatments of 100 mg ketamine or 4.5 mg midazolam...
March 1, 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29501990/features-of-dissociation-differentially-predict-antidepressant-response-to-ketamine-in-treatment-resistant-depression
#19
Mark J Niciu, Bridget J Shovestul, Brittany A Jaso, Cristan Farmer, David A Luckenbaugh, Nancy E Brutsche, Lawrence T Park, Elizabeth D Ballard, Carlos A Zarate
BACKGROUND: Ketamine induces rapid and robust antidepressant effects, and many patients also describe dissociation, which is associated with antidepressant response. This follow-up study investigated whether antidepressant efficacy is uniquely related to dissociative symptom clusters. METHODS: Treatment-resistant patients with major depressive disorder (MDD) or bipolar disorder (BD) (n = 126) drawn from three studies received a single subanesthetic (0.5 mg/kg) ketamine infusion...
May 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29475018/kynurenine-pathway-metabolism-and-the-neurobiology-of-treatment-resistant-depression-comparison-of-multiple-ketamine-infusions-and-electroconvulsive-therapy
#20
A P Allen, M Naughton, J Dowling, A Walsh, R O'Shea, G Shorten, L Scott, D M McLoughlin, J F Cryan, G Clarke, T G Dinan
Current first-line antidepressants can take weeks or months to decrease depressive symptoms. Low dose ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, shows potential for a more rapid antidepressant effect, with efficacy also evident in previously treatment-resistant populations. However, a greater understanding of the physiological mechanisms underlying such effects is required. We assessed the potential impact of ketamine infusion on neurobiological drivers of kynurenine pathway metabolism in major depression (HPA axis hyperactivity, inflammation) in patients with treatment-resistant depression compared to gender-matched healthy controls...
May 2018: Journal of Psychiatric Research
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