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.
Molecular Psychiatry
July 8, 2026
Granville J. Matheson, Johan Lundberg, Martin Gärde et al.
The serotonin 1B receptor (5-HT1BR) can be imaged in living humans using a PET tracer called [11C]AZ10419369 and is linked to major depressive disorder (MDD) and its treatment. Ketamine and electroconvulsive therapy (ECT) are rapid-acting antidepressants that raise serotonin levels, but whether they directly alter serotonin receptors was unclear. Reanalyzing 222 PET scans from three centers—including MDD patients before and after ketamine (19 completers), saline placebo (10), or ECT (13 completers)—using a hierarchical Bayesian method, the authors demonstrate large increases in 5-HT1BR binding after both ketamine (6.4%, 95% CI: 3.1–9.6%) and ECT (9.3%, 95% CI: 4.3–14.2%).
Neuropsychopharmacology
July 7, 2026
Wojciech Pasławski, D Doyon, Carl Johan Ekman et al.
Psilocybin, a rapid-acting antidepressant, reduces levels of the neuropeptide galanin and noradrenaline in cerebrospinal fluid, suggesting that normalization of these co-transmitters is a key pharmacodynamic effect. This finding comes from a secondary analysis of a randomized, placebo-controlled trial with multimodal biomarker measurements. The results indicate a selective effect of psilocybin on these specific neurotransmitters, offering insight into its mechanism of action in major depressive disorder.
The journal of ECT
March 19, 2026
Jennifer Sjödin, Karin Zimmer, Max Bell et al.
Electroconvulsive therapy (ECT) is effective for severe or treatment-resistant major depressive disorder, but anesthesia may reduce its impact by raising the seizure threshold. A review of 59 studies found that ketamine and etomidate produce longer seizures than other anesthetics, though etomidate suppresses cortisol synthesis and ketamine can cause perceptual disturbances. Lower anesthetic doses and longer intervals between anesthesia and ECT are linked to longer seizures and better response, but this has not been confirmed in randomized trials. Clinical outcomes are broadly similar across anesthetics, though ketamine may speed ECT's effect. Anesthetic choice should consider patient factors like cardiovascular health.