Laboratório de Neuropsicofarmacologia (LANP), Psychiatry Service, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Universidade Federal da Bahia, Rua Dr. Augusto Viana, s/n-Canela, Salvador, Bahia, 40110-060, Brazil.
2 papers in the library · 14 citations · publishing 2024
Arketamine, an enantiomer of ketamine, has been less studied than esketamine or racemic ketamine, but recent preclinical work suggests it may have prolonged antidepressant effects and a better safety profile. This scoping review of 20 studies involving 410 subjects found arketamine was primarily investigated for pain management and depression. Early evidence indicates it may reduce pain, though most studies were small and in non-clinical settings. In psychiatry, trials show potential antidepressant effects, but results are inconsistent and some studies unpublished. A consistent finding is arketamine's favorable safety profile, with fewer dissociative and psychotomimetic effects than esketamine or racemic ketamine. Larger, well-designed studies are needed to determine its therapeutic potential.
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.