Effectiveness and Safety of Ketamine for Unipolar Depression: a Systematic Review

Memon, Raheel Imtiaz; Sattar, Naveed; Faquih, Amber Ehsan; Fida, Ania; Abbas, Noureen; Chaudhary, Amna Mohyud Din; Qayyum, Zheala

doi:10.1007/s11126-020-09830-6

Cited by 15 publications

(18 citation statements)

References 45 publications

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“…3 Several recent RCTs have highlighted the potential for a rapid onset of antidepressant effects of ketamine, although gains may be lost within days or weeks. 4 A similar response pattern was previously observed in studies of sleep deprivation, with dramatic reductions in depression after 24-48 h of prolonged wakefulness, but early symptomatic relapse the morning after restoration of normal sleep (so-called recovery sleep). 5 However, further experimentation identified that the combination of sleep deprivation with sleep-phase advance and light therapy (so-called triple chronotherapy, TCT) could lead to rapid and sustained response in major depression.…”

supporting

confidence: 67%

Time to put a spotlight on out-patient chronotherapy for depression

Kallestad

Scott

2021

BJPsych open

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Summary The challenge of identifying efficacious out-patient treatments for depression is amplified by the increasing desire to find interventions that reduce the time to sustained improvement. One potential but underexplored option is triple chronotherapy (TCT). To date, use of TCT has been largely restricted to specialist units or in-patients. Recent research demonstrates that it may be possible to undertake sleep deprivation in out-patient settings, raising the possibility of delivering TCT to broader populations of individuals with depression. Emerging evidence suggests that out-patient TCT is a high-benefit, low-risk intervention but questions remain about how to target TCT and its mechanisms of action. Like traditional antidepressants, TCT probably acts through several pathways, especially the synchronisation of the ‘master clock’. Availability of reliable and valid methods of out-patient measurement of intra-individual circadian rhythmicity and light exposure are rate-limiting steps in the wider dissemination of TCT.

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supporting

confidence: 67%

Time to put a spotlight on out-patient chronotherapy for depression

Kallestad

Scott

2021

BJPsych open

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“…Subanesthetic ketamine administered intravenously dramatically decreases symptoms within 2–4 h with an efficacy of 70–80% [ 66 – 69 ]. Maintaining improvement longer than 1 week post-infusion has motivated strategies for sustaining responses including administering repeated doses [ 70 ] and adding adjunctive treatments [ 71 ].…”

Section: The Circadian Clockmentioning

confidence: 99%

“…In rodents, ketamine was shown to reduce depressive-like behavior starting 30 min postinjection (paralleling changes in BDNF and mTOR levels in the hippocampus) with antidepressant effects lasting for several days [ 81 , 83 ]. For MDD patients, the onset of improvement ranged between 40 and 120 min and was sustained from 2 h to 7 days [ 69 ].…”

Section: The Circadian Clockmentioning

confidence: 99%

Rapid-acting antidepressants and the circadian clock

Sato

Bunney

Mendoza-Viveros

et al. 2021

Neuropsychopharmacol.

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“…With regards to ketamine's utility in depression, a review of 35 randomized controlled trials (RCTs) evaluating the benefits of ketamine for MDD found that intravenous ketamine was an effective treatment in approximately two-thirds of the trials (70%; Memon et al, 2020). While most studies evaluated the role of IV ketamine, a systematic review assessing the utility of oral ketamine for depression across 13 studies (Rosenblat et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study

Davis

Mangini

Xin

2021

JPS

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Trauma exposure across the lifespan produces risks for posttraumatic stress disorder (PTSD), depression, anxiety, as well as global disability in functioning. This retrospective clinical chart review is the first of its kind to assess the utility of sublingual ketamine-assisted body-centered psychotherapy in trauma-exposed patients in a real world clinic setting. De-identified clinical records data on self-reported symptom measures were retrospectively analyzed for patients (N = 18; M age = 45.22, SD = 12.90) entering ketamine-assisted psychotherapy treatment in an outpatient clinic between 2018 and 2020. Patients who completed six sessions of ketamine therapy reported meaningful (e.g., medium effect size) improvements in PTSD symptoms (P = 0.058; d = −0.48) and global disability in functioning (P = 0.050; d = −0.52) and statistically significant and meaningful improvements in depression (P = 0.019; d = −0.53). There were no improvements in anxiety symptoms. Sublingual ketamine-assisted psychotherapy was associated with heterogenous clinical utility among patients with trauma-exposure in an outpatient setting. This study was underpowered and unrepresentative of the population of ketamine patients in the United States. Replication of these findings is needed with larger and more diverse patient samples.

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Effectiveness and Safety of Ketamine for Unipolar Depression: a Systematic Review

Cited by 15 publications

References 45 publications

Time to put a spotlight on out-patient chronotherapy for depression

Time to put a spotlight on out-patient chronotherapy for depression

Rapid-acting antidepressants and the circadian clock

Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study

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