Oral Ketamine for Depression

Rosenblat, Joshua D.; Carvalho, André F.; Li, Madeline; Lee, Ye-Na; Subramanieapillai, Mehala; McIntyre, Roger S.

doi:10.4088/jcp.18r12475

Cited by 88 publications

(58 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, it can be used to evaluate CNS symptoms and the effects of short-term interventions for the treatment of patients with suicidal behavior, since it allows the assessment of five specific domains, i.e., somatic, mood, cognitive, fatigue, and gastrointestinal outcomes linked to anxiety that can develop in patients during ketamine intake [22]. Evidence suggests that short-or long-term use of esketamine nasal spray is highly unlikely to be associated with withdrawal syndrome, as shown by the scores regarding stability, frequency, onset, and severity assessed by PWC-20 [23,24].…”

Section: Central Nervous System Safety Of Ketamine In Depression Treamentioning

confidence: 99%

Safety and Tolerability of Ketamine Use in Treatment-Resistant Bipolar Depression Patients with Regard to Central Nervous System Symptomatology: Literature Review and Analysis

Włodarczyk

Cubała

2020

Medicina

View full text Add to dashboard Cite

The current psychopharmacological treatment approaches for major depression focus on monoaminergic interventions, which are ineffective in a large proportion of patients. Globally, treatment-resistant bipolar depression (TRBD) affects up to 33% of depressive patients receiving treatment. Certain needs are still unmet and require new approaches. Many studies are in favor of treatments with ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, even in single use, whose effects emerge in minutes to hours post administration. However, little data are available on ketamine performance in TRBD patients with somatic comorbidities, including highly prevalent ones, i.e., cardiovascular disease (heart failure, hypertension, post-myocardial infarct, arrhythmias, etc.) diabetes, and obesity, and depression-associated comorbidities such as stroke, epilepsy, as well as in the elderly population. The literature shows that treatment with ketamine is efficacious and safe, and the majority of adverse drug reactions are mild and tend to mostly disappear within 30 min to 2 h of ketamine administration.

show abstract

Section: Central Nervous System Safety Of Ketamine In Depression Treamentioning

confidence: 99%

Safety and Tolerability of Ketamine Use in Treatment-Resistant Bipolar Depression Patients with Regard to Central Nervous System Symptomatology: Literature Review and Analysis

Włodarczyk

Cubała

2020

Medicina

View full text Add to dashboard Cite

show abstract

“…Overall, the evidence base for the benefit of non-IV forms of racemic ketamine remains limited. Efficacy wise, the initial finding of Berman et al has since been well replicated in randomized controlled trials of IV ketamine in TRD subjects, and further confirmed beyond doubt by several meta-analyses (3,16,(6)(7)(8)13).…”

Section: How Can Ketamine Be Administered? Is It Effective In Alleviamentioning

confidence: 83%

“…The intravenous route of administration is the most studied for the acute treatment of TRD, with the majority of data coming from single infusions that produced rapid antidepressant effects within hours and lasting up to a week. Such benefit has been confirmed by several metaanalyses of a significant number of RCTs (6)(7)(8)13). The dose of ketamine used ranged from 0.5 to 1mg per kg, usually infused over 30-45 minutes.…”

Section: How Can Ketamine Be Administered? Is It Effective In Alleviamentioning

confidence: 90%

“…Three small RCTs found early evidence for the benefit of adjunctive oral ketamine in TRD. However, high heterogeneity and variability in the degree of benefit (probably related to differences in bioavailability) limit interpretation (13). The IN formulation of racemic ketamine holds promise with better bioavailability versus the oral form but requires a specific delivery system for its use (14).…”

Section: How Can Ketamine Be Administered? Is It Effective In Alleviamentioning

confidence: 99%

See 1 more Smart Citation

Party drug to mainstream medicine; the transition of ketamine

Ravindran

2020

Sri Lanka J. Psyc.

View full text Add to dashboard Cite

Ketamine reached its prominence as a safe anesthetic agent in the mid 1960's but transitioned into a party drug when its dissociative and hallucinogenic properties were discovered by the club culture (1). By 1980, ketamine use was strongly discouraged purportedly because of its psychotomimetic properties (2). The transition of ketamine to a magical antidepressant began when Berman and colleagues first reported its marked and rapid benefit for treatment-resistant depression (TRD) (3). Ketamine is now hailed as the most important advance in the treatment of depression since the discovery of tricyclics. Major depressive disorder (MDD) is now recognized as a significant public health issue and a leading cause of disability worldwide (4). In spite of available first line interventions that include antidepressants and psychotherapy, at least a third of patients fail to achieve remission (5). Furthermore, antidepressants need significant lag time to benefit, while evidence-based psychotherapies are often difficult to access and costly (5). This is especially true in low-and middle-income countries (LMICs). Thus, there is an unmet need for cost-effective novel interventions with superior efficacy and rapid relief of symptoms. In light of accumulating evidence ketamine appears to be one such agent with promise (6-8).

show abstract

“…Although ketamine may offer a rapid antidepressant effect in cases of bipolar depression, unfortunately the effect is not sustained in the long term. While one option is repeated ketamine infusions [78], the feasibility, accessibility and resources required can limit availability and other routes of administration (oral, sublingual, intranasal, intramuscular, subcutaneous) could prove preferred alternatives for repeat administrations [79]. However, comparatively fewer studies have fully evaluated these alternative routes and further investigation is warranted.…”

Section: Ketaminementioning

confidence: 99%

The Treatment of Bipolar Depression: Current Status and Future Perspectives

Jelen

Young

2020

Curr Behav Neurosci Rep

View full text Add to dashboard Cite

Purpose of Review This paper aims to review current available treatment options and to consider future directions in the treatment of bipolar depression. Recent Findings There are a limited number of established treatments that have demonstrated varied efficacy in acute bipolar depression including modern antipsychotics (quetiapine, lurasidone, olanzapine ± fluoxetine and recently cariprazine) and mood stabilisers (lamotrigine and valproate). Lithium has a role in protecting against depressive relapses and suicide. Alternative and experimental treatments including pramipexole, modafinil/armodafinil, omega-3 fatty acids and thyroxine may be used to augment the treatment of bipolar depression. Ketamine represents a major breakthrough, producing rapid reductions in depressive symptoms even in cases of treatment-resistance, but challenges remain in how best to maintain response and reduce unwanted side effects. Summary There remains uncertainty with regard to the relative efficacy and safety of established and experimental treatments for bipolar depression. Further work using consistent and optimal trial designs and further investigation into novel compounds and treatment interventions are warranted.

show abstract

Oral Ketamine for Depression

Cited by 88 publications

References 0 publications

Safety and Tolerability of Ketamine Use in Treatment-Resistant Bipolar Depression Patients with Regard to Central Nervous System Symptomatology: Literature Review and Analysis

Safety and Tolerability of Ketamine Use in Treatment-Resistant Bipolar Depression Patients with Regard to Central Nervous System Symptomatology: Literature Review and Analysis

Party drug to mainstream medicine; the transition of ketamine

The Treatment of Bipolar Depression: Current Status and Future Perspectives

Contact Info

Product

Resources

About