Archives of General Psychiatry
March 1, 2000
Amit Anand, Dennis S. Charney, Dan A. Oren et al.
425 citations
A drug that inhibits glutamate release, lamotrigine, reduced several effects of ketamine in healthy adults. Lamotrigine given before ketamine decreased perceptual abnormalities, positive and negative schizophrenia-like symptoms, and learning and memory impairment. However, it increased the immediate mood-elevating effects of ketamine. These findings suggest that glutamate release plays a role in some effects of NMDA receptor blockade and that drugs reducing glutamate release might help treat conditions like schizophrenia, though more research is needed.
JAMA network open
June 3, 2024
Manish Kumar Jha, Samuel T Wilkinson, Kamini Krishnan et al.
29 citations
In people with treatment-resistant depression who do not have psychosis, intravenous ketamine works as well as electroconvulsive therapy (ECT) overall. Among outpatients with moderately severe or severe depression, ketamine produced greater improvement in depressive symptoms than ECT. In contrast, inpatients with very severe depression improved more with ECT early in treatment, though by the end of the three-week course both treatments were similarly effective. Higher premorbid intelligence and a diagnosis of posttraumatic stress disorder were linked to greater improvement with ECT, but not with ketamine. These findings may help patients and clinicians decide between the two treatments.
Journal of affective disorders
January 1, 2020
Roman M Dale, Kelly A Bryant, Nora Finnegan et al.
17 citations
In people with treatment-resistant depression who had previously failed electroconvulsive therapy, higher openness to experience—a personality trait reflecting curiosity and willingness to try new things—was the only factor among the Big Five personality domains that significantly predicted a sustained response to repeated intravenous ketamine infusions. The study of 125 participants confirmed that, regardless of treatment response, the group as a whole showed elevated neuroticism, low conscientiousness, and low extraversion. The authors suggest that assessing openness could help identify patients most likely to benefit from long-term ketamine therapy and reduce unnecessary exposure to its unknown risks, though they note limitations including the lack of a placebo control, small sample, and non-standardized infusion schedules.
JAMA Psychiatry
December 1, 2023
Sanjay J. Mathew, Manish K. Jha, Amit Anand
8 citations
Electroconvulsive therapy (ECT) and ketamine are both used to treat treatment-resistant depression (TRD), but recent reports highlight important considerations when comparing them. This viewpoint examines key issues from several recent studies, including differences in how quickly each treatment works, their side effects, and the practical challenges of administering them. ECT remains highly effective but requires anesthesia and can cause memory problems, while ketamine offers rapid relief but its long-term effects and optimal dosing are still being studied. The authors suggest that neither treatment is clearly superior for all patients, and the choice depends on individual circumstances and preferences.
Psychiatry research
May 1, 2025
Gerard Sanacora, Brian S Barnett, Bo Hu et al.
2 citations
Patients with treatment-resistant depression who preferred ketamine over electroconvulsive therapy (ECT) were more likely to respond to treatment, regardless of which treatment they actually received. Matching patients to their preferred treatment improved response rates for ketamine but not for ECT, and reduced adverse events for ECT-treated patients. Ketamine was the more popular choice overall. The findings suggest that aligning treatment with patient preference can influence effectiveness, safety, and possibly adherence, but these effects vary by treatment modality and context.
Contemporary clinical trials
February 1, 2025
Noreen A Reilly-Harrington, Tatiana Falcone, David A Jobes et al.
A randomized controlled trial is testing whether ketamine infusions, compared to placebo, rapidly reduce severe suicidality in youth and young adults (ages 14-30) hospitalized with suicidal ideation or after a suicide attempt. Participants receive up to six treatments of ketamine or placebo while also engaging in Collaborative Assessment and Management of Suicidality (CAMS) sessions, a suicide-focused therapy, starting in the hospital and continuing after discharge. The study enrolls 140 participants and follows them for three months. The hypothesis is that ketamine will produce faster improvement in suicidality, enhance engagement in CAMS, and reduce suicide attempts, emergency visits, and readmissions compared to placebo.
Psychiatric Annals
February 1, 2020
Hatice Guncu Kurt, Murat Altinay, Amit Anand
Patients unresponsive to two antidepressant trials are considered to have treatment-resistant depression (TRD). A review of open-label studies found that various pharmacological and brain stimulation treatments produce similar response rates of 30% to 70% and remission rates of 20% to 50%. In randomized placebo-controlled trials, response rates ranged from 15% to 60% and remission rates from 10% to 40%. Ketamine and electroconvulsive therapy achieve rates at the higher ends of these ranges, with the advantage of rapid action in acute settings. Direct comparative studies with large samples are needed to determine if one treatment offers greater benefit.