Anxiety during ketamine infusions is associated with negative treatment responses in major depressive disorder

Aust, Sabine; Gärtner, Matti; Basso, Laura; Otte, Christian; Wingenfeld, Katja; Chae, Woo Ri; Heuser-Collier, Isabella; Regen, Francesca; Cosma, Nicoleta Carmen; Hall, Franziska van; Grimm, Simone; Bajbouj, Malek

doi:10.1016/j.euroneuro.2019.02.005

Cited by 38 publications

(33 citation statements)

References 43 publications

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“…Nevertheless, our findings are in line with reports that list anxiety as one of the most common side effects of ketamine treatment for depression (Short et al, 2017;Aust 2019).…”

Section: Discussionsupporting

confidence: 93%

“…In fact, ketamine itself (in the absence of the CUS) reduced the number of entries into the center of the open field arena, indicating a potential anxiogenic-like effect of the drug. In support of this interpretation, it has been well documented that anxiogenesis is one of the unwanted side effects of ketamine treatment (Short et al, 2017;Aust 2019). It is also reported that the anxiogenic effects of ketamine are transient, resolving within hours of administration (Bobo et al, 2016).…”

Section: Discussionmentioning

confidence: 81%

“…Furthermore, reports from clinical trials actually list anxiety as one of the most common side effects of ketamine treatment for depression (Short et al, 2017;Aust 2019). The literature also suggests that the anxiogenic effects of ketamine are transient, lasting only a couple of hours (Bobo et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

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Novel Treatment Strategies for Major Depressive Disorder: Investigating Ketamine’s Antidepressant Effects and the Role of the c-Jun N-Terminal Kinase Pathway

Clarke¹

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Current first-line treatments for depression, namely monoamine-based drugs such as SSRIs, take weeks to show any clinical effects, and they are only effective in 60-70% of patients. There is therefore an urgent need to develop more rapid and efficacious treatments. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist often used as a dissociative anesthetic, has been found to have rapid (within hours) antidepressant effects, even in historically treatment-resistant patients. Nevertheless, ketamine has its own limitations, such as unwanted side effects and abuse potential. The overarching goal of this thesis was to gain a better understanding of the antidepressant mechanisms of ketamine. Dedication To my family, all of you. Only you know how long this road has really been, and your support has been absolutely paramount. Thank you. v Table of Contents Abstract…………………………………………………………………………………ii Acknowledgements…………………………………………………………………..iii Dedication……………………………………………………………………………...iv Table of Contents…………………………………………………………………......v List of Figures…………………………………………………………………….....viii List of Abbreviations………………………………………………………………..xi Preface………………………………………………………………………………...xiii Chapter 1. General Introduction…………………………………………………1 Chapter 2. Ketamine modulates pro-inflammatory cytokines, but not stressor-induced neurochemical changes……………………………………...27

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“…Nevertheless, our findings are in line with reports that list anxiety as one of the most common side effects of ketamine treatment for depression (Short et al, 2017;Aust 2019).…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Novel Treatment Strategies for Major Depressive Disorder: Investigating Ketamine’s Antidepressant Effects and the Role of the c-Jun N-Terminal Kinase Pathway

Clarke¹

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“…Most reliably the intensity of dissociative experiences as assessed by the Clinician-Administered Dissociative States Scale during administration has been found to correlate positively with subsequent antidepressant effect [20]. Nonreplicated outcomes have found a negative correlation of response with anxiety during administration [21], correlations with quantitative EEG [22][23][24] and polysomnography parameters [25] as well as an influence of the BDNF Val66Met polymorphism [26]. Neither gender nor age appear to influence antidepressant treatment response [27].…”

Section: Response Predictionmentioning

confidence: 99%

Ketamine in the Treatment of Depressive Episodes

2019

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The treatment of depressive episodes remains complicated by the long latency of antidepressant efficacy, insufficient response, and high risk of suicide. Ketamine and esketamine have been proposed as fast-acting substances able to overcome these impediments.Since the first randomized controlled trial in the year 2000, numerous studies have explored the antidepressant efficacy of ketamine and esketamine. Clear evidence has emerged that a single infusion exerts a significant antidepressant and antisuicidal effect in both unipolar and bipolar depression. A few studies suggest that antidepressant response can be improved and maintained by repeated administration. Although intravenous application has been most common, subcutaneous, intramuscular, and intranasal application has also been successful. There is some evidence that ketamine may accelerate the response to electroconvulsive therapy without improving the overall response rate.The precise position of ketamine and esketamine within treatment algorithms have yet to be defined, and issues surrounding potential toxicity need to be resolved.

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“…Dotychczas nie udało się wyjaśnić, dlaczego u niektórych pacjentów działanie przeciwdepresyjne pojedynczej dawki ketaminy zanika po 1-2 dniach, natomiast u innych utrzymuje się przez kilkanaście dni. Dotychczasowe obserwacje wskazują na to, że lek ten jest mało skuteczny/nieskuteczny u tych pacjentów, którzy podczas wlewu ketaminy doświadczali silnych reakcji lękowych [31]. Wśród potencjalnych czynników, które mogą wskazywać na wydłużone w czasie przeciwdepresyjne działanie ketaminy wymienia się chorobę alkoholową u członków rodziny pierwszego stopnia, brak prób samobójczych, zaburzenia o charakterze dysocjacyjnym (głównie depersonalizacja) w trakcie wlewu leku i zanikające w krótkim czasie po jego zakończeniu, poprawa takich objawów depresji jak smutek i trudności w koncentracji dzień po wlewie, wysoki indeks BMI, niskie podstawowe poziomy adiponektyny, wysokie podstawowe stężenia witaminy B 12 , mutacja Val66Met genu kodującego czynnik neurotroficzny pochodzenia mózgowego (BDNF, ang.…”

Section: Działanie Przeciwdepresyjne Ketaminyunclassified

Ketamine – a prototype of rapidly acting antidepressant drugs

Zawilska¹,

Kacprzak²

2019

Farm Pol.

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Anxiety during ketamine infusions is associated with negative treatment responses in major depressive disorder

Cited by 38 publications

References 43 publications

Novel Treatment Strategies for Major Depressive Disorder: Investigating Ketamine’s Antidepressant Effects and the Role of the c-Jun N-Terminal Kinase Pathway

Novel Treatment Strategies for Major Depressive Disorder: Investigating Ketamine’s Antidepressant Effects and the Role of the c-Jun N-Terminal Kinase Pathway

Ketamine in the Treatment of Depressive Episodes

Ketamine – a prototype of rapidly acting antidepressant drugs

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