Trends in Psychiatry and Psychotherapy
May 27, 2025
Mariana V. F. Echegaray, Rodrigo P. Mello, Guilherme M. Magnavita et al.
11 citations
Among people with treatment-resistant depression, the intensity of dissociation caused by a single infusion of ketamine or esketamine is linked to greater antidepressant effect one day later, but only when dissociative symptoms are mild to moderate. For every one-point increase on a dissociation scale up to 15 points, depression scores improved by an average of 0.5 points after 24 hours. This relationship was not observed at 72 hours or 7 days after infusion. The study was not originally designed to test this relationship, so confounding factors were not controlled, and the finding should be considered suggestive rather than definitive.
Schizophrenia research
September 1, 2024
Ana Teresa Caliman-Fontes, Flávia Vieira, Gustavo C Leal et al.
7 citations
Catatonia, a condition recognized since the 1800s, remains difficult to diagnose and treat. A systematic review of 20 studies involving 25 patients who received ketamine or esketamine for catatonia found that 80% of patients responded to treatment and 44% achieved remission, with no worsening of catatonic or psychotic symptoms. Only one patient stopped treatment due to intolerable dissociative effects. Most patients were female (61.9%), with an average age of 44.4 years, and had underlying mood disorders. The evidence suggests ketamine may be effective for catatonia, even in patients with psychotic disorders, where it has traditionally been considered contraindicated. The authors advocate reevaluating this contraindication, noting potentially greater benefits for those with mood disorders.
Psychiatry research
June 1, 2025
Flávia Vieira, Ana Teresa Caliman-Fontes, Breno Souza-Marques et al.
A systematic review of 46 studies on ketamine and its enantiomers for major depressive disorder identified 16 assessment tools used to measure suicidal behavior. Most were explicit, clinician-rated scales such as the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), and Beck Scales for Suicide Ideation. Only the Suicide Ideation and Behavior Assessment Tool (SIBAT) was specifically developed for rapid-acting antidepressant trials. The variety of instruments used across studies makes comparisons difficult. The MADRS is suggested as a reasonable choice for assessing suicidal behavior in this context, though no single tool is universally preferable.