Efficacy of ketamine for major depressive episodes at 2, 4, and 6-weeks post-treatment: A meta-analysis

Conley, Ashley A; Norwood, Amber E. Q.; Hatvany, T; Griffith, James D.; Barber, KE

doi:10.1007/s00213-021-05825-8

Cited by 23 publications

(24 citation statements)

References 82 publications

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“…Over the last 2 decades, ketamine has become an important research tool to investigate rapid antidepressant mechanisms of action [ 1 ]. It has been repeatedly shown that antidepressant effects of ketamine occur within 24 h after a single dose [ 2 ]. On the one hand, this allows for the study of antidepressant mechanisms, as it enables to establish a direct link between the drug and its effects.…”

Section: Introductionmentioning

confidence: 99%

Acute effects of ketamine on the pregenual anterior cingulate: linking spontaneous activation, functional connectivity, and glutamate metabolism

Gärtner

Weigand

Scheidegger

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Ketamine exerts its rapid antidepressant effects via modulation of the glutamatergic system. While numerous imaging studies have investigated the effects of ketamine on a functional macroscopic brain level, it remains unclear how altered glutamate metabolism and changes in brain function are linked. To shed light on this topic we here conducted a multimodal imaging study in healthy volunteers (N = 23) using resting state fMRI and proton (1H) magnetic resonance spectroscopy (MRS) to investigate linkage between metabolic and functional brain changes induced by ketamine. Subjects were investigated before and during an intravenous ketamine infusion. The MRS voxel was placed in the pregenual anterior cingulate cortex (pgACC), as this region has been repeatedly shown to be involved in ketamine’s effects. Our results showed functional connectivity changes from the pgACC to the right frontal pole and anterior mid cingulate cortex (aMCC). Absolute glutamate and glutamine concentrations in the pgACC did not differ significantly from baseline. However, we found that stronger pgACC activation during ketamine was linked to lower glutamine concentration in this region. Furthermore, reduced functional connectivity between pgACC and aMCC was related to increased pgACC activation and reduced glutamine. Our results thereby demonstrate how multimodal investigations in a single brain region could help to advance our understanding of the association between metabolic and functional changes.

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Section: Introductionmentioning

confidence: 99%

Acute effects of ketamine on the pregenual anterior cingulate: linking spontaneous activation, functional connectivity, and glutamate metabolism

Gärtner

Weigand

Scheidegger

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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“…In 2000, the first double-blind, placebo-controlled trial of ketamine in depressed patients revealed that subanesthetic doses (0.5 mg/kg infused over 40 min) had rapid and robust antidepressant effects [ 108 , 109 ]. Numerous studies have since replicated this finding [ 110 , 111 , 112 , 113 , 114 ], with meta-analyses showing acute and prolonged antidepressant efficacy of single and repeated ketamine administration [ 115 , 116 , 117 , 118 ]. Other studies have described synergistic therapeutic effects when ketamine is administered as an anesthetic adjunct in electroconvulsive therapy (ECT): the gold standard for treating refractory depression [ 119 , 120 , 121 , 122 ].…”

Section: Introductionmentioning

confidence: 94%

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

et al. 2022

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Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive–compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.

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“…In 2000, the first double-blind, placebo-controlled trial of ketamine in depressed patients revealed that subanesthetic doses (0.5 mg/kg infused over 40 minutes) had rapid and robust antidepressant effects [99]. Numerous studies have since replicated this finding [100][101][102][103][104], with metaanalyses showing acute and prolonged antidepressant efficacy of both single and repeated ketamine administration [105][106][107][108]. This eventually led to the approval of intranasal esketamine (Spravato®) for treatment-resistant depression by the Food and Drug Administration (FDA) in 2019 [109,110].…”

Section: Introductionmentioning

confidence: 99%

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

Ragnhildstveit¹,

Slayton²,

Jackson³

et al. 2022

Preprint

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Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairments, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, which exhibits rapid and robust antidepressant effects, particularly among clinical non-responders. It is now being investigated for several new indications, including obsessive-compulsive, post-traumatic, and substance use disorder; and shows transdiagnostic potential for EDs. As such, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination pharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value, yet are limited to case series and reports principally on anorexia nervosa. Further empirical work is thus needed to explore and establish ketamine efficacy for EDs, and to inform targeted treatment strategies.

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Efficacy of ketamine for major depressive episodes at 2, 4, and 6-weeks post-treatment: A meta-analysis

Cited by 23 publications

References 82 publications

Acute effects of ketamine on the pregenual anterior cingulate: linking spontaneous activation, functional connectivity, and glutamate metabolism

Acute effects of ketamine on the pregenual anterior cingulate: linking spontaneous activation, functional connectivity, and glutamate metabolism

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

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