European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
September 1, 2024
Aleksander Kwaśny, Julia Kwaśna, Alina Wilkowska et al.
24 citations
Ketamine, a medication used for depression, may also reduce anhedonia (loss of interest or pleasure). A systematic review of 22 studies (4 randomized-controlled trials and 18 open-label trials) found that all reported alleviation of anhedonia symptoms after ketamine or esketamine administration, regardless of the number of infusions. Neuroimaging studies showed changes in functional connectivity linked to improvement. However, limitations include few placebo-controlled trials. The review suggests a potential anti-anhedonic effect of ketamine in depressed patients, likely through neuroplastic changes.
Medicina
February 9, 2020
Adam Włodarczyk, Wiesław Jerzy Cubała
22 citations
Current treatments for major depression focus on monoaminergic drugs, which fail many patients. Treatment-resistant bipolar depression (TRBD) affects up to 33% of treated depressive patients. Ketamine, an NMDA receptor antagonist, shows promise, with effects emerging minutes to hours after a single dose. However, little data exist on ketamine's performance in TRBD patients with somatic comorbidities like cardiovascular disease, diabetes, obesity, stroke, epilepsy, or in the elderly. The literature indicates ketamine is efficacious and safe; most adverse drug reactions are mild and resolve within 30 minutes to 2 hours of administration.
Neuropsychiatric Disease and Treatment
October 1, 2020
Joanna Szarmach, Wiesław Jerzy Cubała, Adam Włodarczyk et al.
15 citations
In patients with treatment-resistant depression, intravenous ketamine is generally safe and well-tolerated when added to existing psychiatric medications. Blood pressure and heart rate returned to baseline within 90 minutes after each infusion, with no lasting complications. However, larger temporary increases in blood pressure occurred in patients also taking SSRIs, and heart rate decreases were greater in those not taking mood stabilizers. Risks were more pronounced in patients with coexisting high blood pressure or diabetes. The study included 35 people with major depressive disorder and 14 with bipolar disorder.
Medicina
March 16, 2021
Joanna Szarmach, Wiesław Jerzy Cubała, Adam Włodarczyk et al.
14 citations
Ketamine treatment for treatment-resistant depression has a good safety and tolerability profile, but patients with metabolic and cardiovascular comorbidities require risk mitigation. In a naturalistic observational study of 49 inpatients with major depressive disorder or bipolar disorder, those with hypertension showed a greater increase in systolic blood pressure after the second infusion compared to those without hypertension. Patients with diabetes mellitus had significant differences in heart rate after infusions 2, 7, and 8, and a higher increase in diastolic blood pressure. Hyperlipidemic patients experienced a greater decrease in heart rate after infusion 5 and systolic blood pressure after infusion 4. Stroke survivors had higher increases in diastolic blood pressure after infusions 4 and 6. Epilepsy patients had a greater decrease in systolic blood pressure after the 8th infusion.
Asian journal of psychiatry
June 1, 2024
Adam Włodarczyk, Jakub Słupski, Joanna Szarmach et al.
12 citations
A year-long follow-up of three adults with treatment-resistant depression who received a single intravenous dose of arketamine (R-ketamine) found substantial symptom reduction and improved social and vocational functioning, including reduced sick leave and hospitalizations. One participant developed a substance use disorder, highlighting the need for careful monitoring. The findings suggest arketamine may offer a transformative approach to managing depression, with fewer dissociative side effects and lower abuse potential than esketamine, but the small sample size and lack of randomization require cautious interpretation.
Pharmaceuticals
January 24, 2023
Adam Włodarczyk, Alicja Dywel, Wiesław Jerzy Cubała
10 citations
In patients with treatment-resistant depression, intravenous ketamine may elevate psychotic symptoms in those with epilepsy. Among 49 inpatients with major depressive or bipolar depression treated with ketamine, the presence of epilepsy was significantly associated with an increase in Brief Psychiatric Rating Scale scores over time. For the subgroup with epilepsy (6 patients), substantial fluctuations occurred across all administrations. Psychotic symptoms for other comorbid conditions were not significant. The findings indicate that careful consideration of comorbidities and close clinical supervision are needed during ketamine treatment.
Therapeutic Advances in Psychopharmacology
January 1, 2021
Adam Włodarczyk, Wiesław Jerzy Cubała, Maria Gałuszko‐węgielnik et al.
8 citations
In treatment-resistant inpatients with major depressive disorder (MDD) or bipolar disorder (BP), intravenous ketamine was generally well-tolerated with no lasting neurological harm. However, certain concurrent medications were linked to more psychomimetic and dissociative symptoms. Patients taking the antidepressant citalopram reported greater psychomimetic effects. Classic mood stabilizers—lamotrigine, valproate, and lithium—were each significantly associated with increased scores on the Brief Psychiatric Rating Scale. No long-term adverse effects were observed. The findings suggest that ketamine treatment requires careful monitoring for dissociative and psychomimetic symptoms, especially when combined with specific psychotropic drugs.
Frontiers in psychiatry
January 1, 2024
Aleksander Kwaśny, Wiesław Jerzy Cubała, Adam Włodarczyk
7 citations
Anhedonia, a reduced ability to experience pleasure, is a core depression symptom that often persists despite standard treatments. Ketamine appears to have antianhedonic effects. In a naturalistic study of 28 inpatients with treatment-resistant depression, both responders and non-responders to ketamine therapy showed significant reductions in anhedonia over time, as measured by the Snaith-Hamilton Pleasure Scale. Non-responders also reported significant improvement in self-reported depression at the seventh infusion, but not at follow-up. Changes in depressive symptoms and anhedonia did not fully overlap, suggesting ketamine may alleviate anhedonia as a separate symptom domain regardless of overall treatment response.
Frontiers in Psychiatry
December 2, 2021
Maria Gałuszko‐węgielnik, Adam Włodarczyk, Wiesław Jerzy Cubała et al.
5 citations
Repeated series of intravenous ketamine infusions, given as an add-on treatment, can be effective and safe for patients with treatment-resistant depression. In a case series of five inpatients aged 43–63 with major depressive disorder or bipolar I disorder, four achieved remission after the first series of eight infusions, and three after the second series. Adverse reactions were mild and transient. The results are limited to short-term, add-on intravenous ketamine and cannot be generalized to long-term maintenance or other formulations.
Pharmacological reports : PR
December 1, 2024
Aleksander Kwaśny, Wiesław Jerzy Cubała, Adam Włodarczyk et al.
2 citations
In a small observational study of 28 inpatients with treatment-resistant major depressive disorder, neither those who responded to ketamine treatment nor those who did not reported significant changes in self-reported sleep problems—including insomnia, nighttime restlessness, early morning waking, or hypersomnia—after eight intravenous ketamine infusions over seven days. These results contrast with previous research that had suggested modest sleep improvements with ketamine. The authors caution that the small sample size limits the reliability of the findings.
Frontiers in Nutrition
August 21, 2025
Jakub Słupski, Agnieszka Mechlińska, Adam Włodarczyk et al.
1 citation
A systematic review of five studies involving 678 participants examined how ketamine treatment affects appetite in people with treatment-resistant mood disorders. Two studies found significant improvement in reduced appetite after ketamine or esketamine treatment; one found no significant change; one reported a paradoxical worsening; and one noted minimal effect on increased appetite and atypical symptoms. The evidence suggests ketamine may improve depressive symptoms including appetite, or have neutral effects. Measuring appetite could help detect antidepressant effects beyond traditional medications and aid treatment planning for patients with metabolic disorders or malnutrition risk.
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
1 citation
In patients with treatment-resistant depression, intravenous ketamine appears safe regarding dissociative and psychotic symptoms, but those with epilepsy require close monitoring. Among 49 inpatients with major depressive or bipolar disorder and somatic comorbidities, psychotic symptom scores changed significantly over time only in the epilepsy subgroup. For other somatic conditions, no significant psychotic symptom changes occurred regardless of depression diagnosis. The study was small, unblinded, and limited to a single site, so findings are preliminary.
Frontiers in Psychiatry
December 4, 2025
Adam Włodarczyk, Jakub Słupski, Joanna Szarmach et al.
Ketamine may be a viable treatment option for patients with treatment-resistant post-stroke depression. Further research is needed to better understand its efficacy and safety in this specific patient population.
Magnesium research
Jakub Słupski, Adam Włodarczyk, Natalia Górska et al.
Impulsive behaviors are common in major depressive disorder and bipolar disorder, raising suicide risk and mood instability. Ketamine, an NMDA receptor antagonist, can produce rapid antidepressant and antisuicidal effects, and magnesium given with low-dose NMDA antagonists reduces anxiety- and depression-like behaviors in animals. This observational study of 49 inpatients with treatment-resistant mood disorders measured impulsivity with the Barratt Impulsiveness Scale (BIS-11) and magnesium levels before and during a four-week course of eight ketamine infusions. Magnesium ion concentration during treatment was not associated with changes in BIS-11 scores. The findings provide no evidence for a relationship between magnesium levels and impulsivity during ketamine therapy.
Research Square (Research Square)
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
In hospitalized patients with treatment-resistant depression (major depressive or bipolar disorder), intravenous ketamine treatment was associated with changes in psychotic symptoms over time among those with epilepsy, but not among those with other somatic conditions. The study, which included 49 participants and was limited by a small, unblinded, single-site design, suggests that careful monitoring for psychotic symptoms is needed when using ketamine in patients with epilepsy, and that somatic comorbidities may influence dissociative side effects.