EClinicalMedicine
May 7, 2022
Hewa Artin, Sean Bentley, Eamonn Mehaffey et al.
35 citations
In an open-label retrospective analysis of 35 Veterans with co-occurring depression and PTSD, repeated intranasal (S)-ketamine treatments over four weeks were associated with reductions in both depression and PTSD symptoms. Depression scores on the PHQ-9 fell by an average of 5.1 points, from 19.8 to 14.7, with 14% of patients showing a clinically meaningful response. PTSD scores on the PCL-5 dropped by an average of 15.5 points, from 54.8 to 39.3, with 46% showing a clinically meaningful response. Changes in depression and PTSD symptoms were only moderately correlated, and some individuals experienced PTSD improvement without antidepressant response, suggesting distinct mechanisms of action for the two conditions.
Psychiatry research
May 1, 2024
Eric A Miller, Houtan Totonchi Afshar, Jyoti Mishra et al.
12 citations
Ketamine helps some patients with treatment-resistant depression, but predicting who will respond is difficult. Analyzing symptom trajectories from 120 patients treated with ketamine or esketamine in a real-world clinic, all symptoms improved on average, with depressed mood improving faster than low energy. A principal component analysis identified overall treatment response and a second component reflecting differences between affective and somatic symptoms. Logistic regression classifiers predicted overall response better than chance using baseline symptoms alone. By adjusting decision thresholds, models identified 22% of patients who would not respond with over 96% negative predictive value, potentially guiding treatment recommendations to avoid ineffective treatments.
Biological psychiatry global open science
November 1, 2024
Dhakshin Ramanathan, Jason Nan, Gillian Grennan et al.
10 citations
Consistency of response times during a breath-monitoring task, measured with electroencephalography in 324 people aged 15 to 91, correlates with attentive performance on an exteroceptive inhibitory control task. On-task alpha band activity (8-12 Hz) was greater than at rest. Low-consistency and longer breath responses were associated with elevated brain activity, particularly in posterior default mode network (pDMN) regions. pDMN activity was inversely linked with functional connectivity to frontal networks during the task but not at rest, suggesting frontal networks regulate pDMN activity during interoceptive attention. Greater pDMN activity in the precuneus was linked to lower subjective mindfulness and was adaptively modulated by task difficulty. Elevated pDMN alpha activity serves as an objective neural marker for low-consistency responding during interoceptive breath attention.
JMIR formative research
July 17, 2025
Satish Jaiswal, Jason Nan, Seth Dizon et al.
5 citations
A pilot study tested a parent-child digital mindfulness and compassion training app called Cooperative Compassion (CoCo) with 24 families. After 30 sessions over three months, the program was feasible, with 80% of families completing most sessions. Children showed no significant improvement in depression scores but did demonstrate faster processing on an emotion task. Parents experienced significant reductions in stress, anxiety, and depression that lasted at three months, and their mindfulness gains correlated with stress relief. Brain recordings during a breathing task revealed reduced default mode network activity after training, suggesting less mind-wandering and better focus. The results support larger, randomized trials.
Psychedelic medicine (New Rochelle, N.Y.)
August 1, 2025
Kush V Bhatt, Jason N Compton, Em Ellerman et al.
1 citation
Mystical experiences, which may have therapeutic value, occurred in about 17-18% of ketamine treatments among 60 veterans with treatment-resistant depression. In those receiving esketamine, more treatment sessions were linked to higher mystical experience scores; in those receiving racemic ketamine, higher doses were linked to higher scores. The findings suggest that ketamine can occasion mystical experiences in this population.
Psychiatric Research and Clinical Practice
July 2, 2026
Kush V. Bhatt, Tara Austin, Danny Alam et al.
Intramuscular (IM) ketamine is as effective as intranasal (IN) esketamine for treatment-resistant depression, with comparable safety and a dramatically lower cost. In a retrospective cohort of 179 Veterans, the difference in depression symptom improvement was only 0.04 points on the PHQ-9, well within the non-inferiority margin. PTSD symptom reductions were also similar, and rates of emergency department visits or hospitalizations did not differ significantly. The cost per eight-treatment course was $6069 for IN esketamine versus $647 for IM ketamine, driven primarily by the cost of the nasal spray. These results indicate that IM ketamine could be a high-value alternative that expands access to care.
Community mental health journal
April 1, 2026
Kush V Bhatt, Joseph Friedman, Lindsay Benster et al.
Recreational psychedelic use is increasing, but data on adverse events is limited. A retrospective chart review of emergency department visits at UC San Diego Medical Center from 2010 to 2023 identified 232 cases linked to LSD (35%), MDMA (30.2%), and psilocybin (24%). Patients were mostly young, white, and male. Common symptoms included agitation (25.9%) and anxiety (24.6%); 11.2% required psychiatric hospitalization. Factors associated with higher odds of hospitalization were concurrent cannabis use (odds ratio 10.9), history of bipolar disorder (odds ratio 12.67), and history of a primary psychotic disorder (odds ratio 17.10). Most psychedelic-related emergency visits are managed without hospitalization, but these specific vulnerabilities predict severe outcomes.
medRxiv Preprint Server
July 3, 2023
Eric A. Miller, Houtan Totonchi Afshar, Jyoti Mishra et al.
preprint
Ketamine helps some patients with treatment resistant depression, but reliable methods for predicting which patients will respond are lacking.
medRxiv Preprint Server
June 28, 2023
Mohammad Ali Shenasa, Houtan Totonchi Afshar, Eric A. Miller et al.
preprint
Cannabis use may weaken the antidepressant effects of ketamine and repetitive transcranial magnetic stimulation (rTMS). The antidepressant effects of these treatments rely on long-term potentiation and synaptic plasticity, but cannabis activates CB1 receptors, which can impair synaptic plasticity. This suggests that cannabis use might reduce the effectiveness of ketamine and rTMS for depression treatment.