Adjunct ketamine treatment effects on treatment-resistant depressive symptoms in chronic treatment-resistant schizophrenia patients are short-term and disassociated from regional homogeneity changes in key brain regions – a pilot study

Ye, Jiaen; Lin, Xiaodong; Jiang, Deguo; Chen, Min; Zhang, Yanchi; Tian, Hongjun; Li, Jie; Zhuo, Chuanjun; Zhao, Yanyan

doi:10.1080/24750573.2019.1699726

Cited by 3 publications

(5 citation statements)

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“…There is debate about whether it counts as a psychedelic, and it is sometimes described as an anti-depressant, a psychotomimetic, or both at once (Hibicke et al, 2020;Ye et al, 2019). 9.…”

Section: Discussionmentioning

confidence: 99%

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Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Friesen

2022

Transcult Psychiatry

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Experiences of psychedelics and psychosis were deeply entangled in scientific practices in the mid-20th century, from uses of psychedelic drugs that could model psychosis, to detailed phenomenological comparisons of endogenous and drug-induced madness. After the moral panic of the 1960s shut down psychedelic research, however, these two phenomena became disentangled. In the decades following, the science of psychosis transformed, shedding the language of psychoanalysis, and adopting the new scientific veneer of psychiatry. Today, as psychedelic science re-emerges, the research programs surrounding psychosis and psychedelics now stand in stark contrast. Here, I look closely at how these research programs respond to questions related to what is worth measuring, what is worth investigating, and how we ought to respond to these experiences. This comparison reveals radically different assumptions and values that guide each research paradigm and shape clinical practice. While psychedelic research often includes scales that seek to capture experiences of mysticism, meaningfulness, and ego dissolution, research related to psychosis focuses on the measurement of pathological symptoms and functioning. Research into psychosis primarily seeks universal and reductionist causal explanations and interventions, while psychedelic research embraces the importance of set and setting in shaping unique experiences. Responses to psychedelic crisis involve warmth, compassion, and support, while responses to psychotic experiences often involve restraint, seclusion, and weapons. I argue that these differences contain important lessons for psychiatry. However, as psychedelic research struggles to meet regulatory requirements and fit within the paradigm of evidence-based medicine, these differences may quickly dissolve.

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“…There is debate about whether it counts as a psychedelic, and it is sometimes described as an anti-depressant, a psychotomimetic, or both at once (Hibicke et al, 2020;Ye et al, 2019). 9.…”

Section: Discussionmentioning

confidence: 99%

“… 8. Ketamine provides another interesting example in this research space, having recently been approved by the FDA for the treatment of depression in the form of esketamine. There is debate about whether it counts as a psychedelic, and it is sometimes described as an anti-depressant, a psychotomimetic, or both at once (Hibicke et al, 2020; Ye et al, 2019). …”

mentioning

confidence: 99%

Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Friesen

2022

Transcult Psychiatry

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“…Para los síntomas negativos, la ketamina produce efectos antidepresivos y antisuicidas rápidos sin eventos adversos graves [ 49 , 62 , 72 ].…”

Section: Desarrollounclassified

“…Ninguno de los pacientes exhibió o informó de efectos secundarios adversos que requirieran intervención médica [ 49 , 72 , 74 ], y los únicos efectos adversos que se experimentaron fueron, en algunos casos, síntomas de desrealización y náuseas [ 73 ], y sedaciones transitorias, náuseas y vómitos [ 62 ], en otros.…”

Section: Desarrollounclassified

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Uso de sustancias psicoactivas como tratamiento de la psicosis

Serrano Jiménez,

de Lucas Moreno

2023

RevNeurol

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Introducción. Los trastornos psicóticos se consideran problemas crónicos de salud mental. Aunque se ha demostrado que estos trastornos pueden presentarse con sintomatologías muy heterogéneas, el tratamiento farmacológico se basa en el uso de antipsicóticos típicos y atípicos, cuyo mecanismo de acción principal es el bloqueo dopaminérgico, limitando su efecto a la mejora de los síntomas positivos, sin mejorar el resto de la sintomatología y presentando una gran cantidad de efectos adversos graves. Por este motivo se están estudiando nuevas dianas terapéuticas distintas al sistema dopaminérgico. El objetivo principal de esta revisión es comprobar si estas sustancias psicoactivas utilizadas en la práctica clínica podrían aportar beneficios adicionales como tratamiento complementario para personas con trastornos psicóticos. Desarrollo. Para esta revisión sistemática se realizó una búsqueda bibliográfica en las bases de datos PsycINFO, Medline, Psicodoc, PubMed y Google Scholar. Se incluyeron 28 artículos en la revisión. Entre los principales resultados encontramos que el cannabidiol es más efectivo para mejorar los síntomas positivos y la psicopatología; el modafinilo, para los síntomas cognitivos, el funcionamiento motor y emocional y la calidad de vida; y la ketamina, para los síntomas negativos. Además, todas las sustancias presentaron un buen perfil de tolerabilidad y seguridad, especialmente en comparación con los antipsicóticos. Conclusión. Con los resultados obtenidos, se abre la posibilidad de tener una guía de actuación para los clínicos/profesionales de la salud sobre el uso del cannabidiol, el modafinilo y la ketamina como tratamiento adyuvante para pacientes con cuadros psicóticos.

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Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy

Muscat

Hartelius

Crouch

et al. 2022

Psych

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Strategically timed trauma- and attachment-informed psychotherapy to address underlying emotional wounds, paired with ketamine administered in precision-calibrated doses to ensure high-entropy brain states, may be key to improving the quality and duration of ketamine’s therapeutic efficacy for treatment-resistant depression. This approach optimizes the opportunities for change created by ketamine’s known effects as a rapid antidepressant that stimulates synaptogenesis, normalizes neural connectivity and coherence, enhances neuroplasticity, reduces inflammation, and induces high-entropy brain states with associated subjective psychedelic experiences. Ketamine, a non-selective N-methyl-D-aspartate (NMDA) receptor antagonist is a safe, effective, fast-acting dissociative anesthetic that, as a standalone treatment, also exhibits rapid sustained antidepressant effects, even in many patients with treatment-resistant depression. A prior history of developmental trauma and attachment injuries are known primary factors in the etiology of treatment resistance in depression and other mental disorders. Thus, the adjunct of targeted psychotherapy attuned to trauma and attachment injuries may enhance and prolong ketamine efficacy and provide an opportunity for lasting therapeutic change. Psychotherapy engagement during repeated ketamine sessions for patient safety and integration of altered states, paired with separate individualized psychotherapy-only sessions timed 24–48 h post ketamine induction, takes advantage of peak ketamine-induced dendritic spine growth in the prefrontal cortex and limbic system, and normalized network connectivity across brain structures. This strategically timed paired-session approach also exploits the therapeutic potential created by precision-calibrated ketamine-linked high-entropy brain states and associated psychedelic experiences that are posited to disrupt overly rigid maladaptive thoughts, behaviors, and disturbing memories associated with treatment-resistant depression; paired sessions also support integration of the felt sense of happiness and connectivity associated with psychedelic experiences.

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Adjunct ketamine treatment effects on treatment-resistant depressive symptoms in chronic treatment-resistant schizophrenia patients are short-term and disassociated from regional homogeneity changes in key brain regions – a pilot study

Cited by 3 publications

References 75 publications

Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Uso de sustancias psicoactivas como tratamiento de la psicosis

Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy

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