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Rebecca McMillan

University of Auckland, Auckland, New Zealand.

2 papers in the library · 148 citations · publishing 2021-2022

Papers

International pooled patient-level meta-analysis of ketamine infusion for depression: In search of clinical moderators

Molecular Psychiatry September 7, 2022 Rebecca B Price, Nicholas Kissel, Andrew Baumeister et al. 80 citations

Ketamine given intravenously rapidly reduces depressive symptoms, with effects lasting at least a week. In an analysis of 17 randomized controlled trials with 809 participants, the benefit over placebo was larger for patients who had already failed two or more prior antidepressant trials. However, no patient-level clinical or demographic characteristics—such as age, sex, or diagnosis—could predict who would respond best, limiting the ability to personalize ketamine prescriptions. The findings confirm ketamine's broad effectiveness for depression but show that precision medicine approaches cannot yet guide treatment decisions.

A qualitative and quantitative account of patient's experiences of ketamine and its antidepressant properties.

Journal of psychopharmacology (Oxford, England) August 1, 2021 Rachael L Sumner, Emme Chacko, Rebecca McMillan et al. 68 citations

Ketamine, given at 0.44 mg/kg to 32 volunteers with major depressive disorder in a crossover design with the active-placebo remifentanil, produced psychedelic experiences that correlated with greater antidepressant response at 24 hours. Specifically, higher scores on spirituality, experience of unity, and insight were linked to larger reductions in depression ratings. Qualitative interviews revealed perceptual changes, loss of control, emotional shifts, a psychedelic afterglow, and lasting changes in perspective on life, people, problems, and depression. The findings suggest the psychedelic experience and afterglow contribute to ketamine's antidepressant effects, and that standard questionnaires may not fully capture these properties.