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Lee Phan

Poul Hansen Family Centre for Depression, Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada. Electronic address: lee.phan@uhnresearch.ca.

7 papers in the library · 353 citations · publishing 2020-2025

Papers

The effect of intravenous, intranasal, and oral ketamine in mood disorders: A meta-analysis.

Journal of Affective Disorders November 1, 2020 R. Mcintyre, Isabelle P. Carvalho, L. Lui et al. 186 citations

Ketamine is a rapid and effective treatment for adults with treatment-resistant depression, but different formulations and routes of delivery vary in effect size. A meta-analysis of studies found that intranasal ketamine or esketamine had a large effect on depression symptoms at 24 hours and again at 7-20 days. Intravenous ketamine or esketamine showed a large but not statistically significant effect at 2-6 days. Oral ketamine had a moderate effect at 21-28 days. No conclusions about which formulation or route is best could be drawn because direct comparisons are lacking. More studies with larger samples are needed, especially for oral ketamine.

The abuse liability of ketamine: A scoping review of preclinical and clinical studies.

Journal of Psychiatric Research May 1, 2022 Tuyen T. Le, Isabel Pazos Cordero, Muhammad Youshay Jawad et al. 82 citations

Ketamine and its enantiomers show different abuse liability. Preclinical evidence indicates that (R,S)-ketamine and (S)-ketamine carry greater risk for abuse than (R)-ketamine, which at antidepressant-relevant doses in rodents appears safe with minimal liability. In clinical settings, limited studies suggest that single or repeated ketamine administrations under professional control did not lead to misuse, dependence, diversion, or gateway activity in patients with treatment-resistant depression. However, most clinical studies were retrospective and lacked systematic evaluation with validated scales. The review identified 65 eligible studies (55 preclinical, 10 clinical), with only 4 preclinical studies evaluating enantiomer abuse liability.

Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder.

Psychiatry Research March 5, 2023 Kevork Danayan, Noah Chisamore, Nelson B Rodrigues et al. 36 citations

Intravenous ketamine reduced symptoms of depression, borderline personality, suicidality, and anxiety in people with treatment-resistant depression and comorbid borderline personality disorder. In a retrospective analysis of 100 participants, those with borderline personality disorder showed significant improvement, with a reduction of 5.95 points on the Quick Inventory of Depressive Symptomatology and a reduction of 0.64 on the Borderline Symptom List. Both groups with and without borderline personality disorder improved similarly on depression, anxiety, and functionality measures, with no significant difference between groups.

Spectral signatures of psilocybin, lysergic acid diethylamide (LSD) and ketamine in healthy volunteers and persons with major depressive disorder and treatment-resistant depression: A systematic review.

Journal of affective disorders June 15, 2024 Gia Han Le, Sabrina Wong, Sebastian Badulescu et al. 25 citations

A systematic review examined how serotonergic psychedelics (psilocybin, LSD) and ketamine affect brain wave patterns measured by EEG and MEG in people with major depressive disorder, treatment-resistant depression, and healthy controls. Ketamine and psychedelics both increase theta power in depressed individuals. In healthy controls and depressed persons, both drug classes decrease alpha, beta, and delta power. Ketamine also increases gamma power in both groups. Theta power specifically rises in those with major depressive disorder when given psychedelics. The studies varied in patient populations, dosing, and measurement devices. The findings support disease models involving altered network connectivity and may guide future treatment discovery.

Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth

Journal of Psychopharmacology May 16, 2023 Noah Chisamore, Kevork Danayan, Nelson B Rodrigues et al. 13 citations

Ketamine infusions led to clinically significant reductions in depression, anxiety, and suicidal thoughts in transitional age youth (ages 18–25) with treatment-resistant depression. In a retrospective analysis of 52 youth matched with a general adult sample (ages 30–60), both groups showed comparable improvements after four infusions over two weeks, with moderate effect sizes and no significant group differences. Adverse effects were mild and transient. The findings suggest ketamine is similarly effective and safe for younger adults as for older adults with treatment-resistant depression.

Non-hallucinogenic psychedelics for mood and anxiety disorders: A systematic review

Psychiatry Research May 8, 2025 Noah Chisamore, Lee Phan, Roger S McIntyre et al. 7 citations

A review of pre-clinical and clinical studies on non-hallucinatory psychedelics (NHPs) for mood and anxiety disorders found five animal studies showing antidepressant-like effects, assessed via forced swim test and open field test, without the head-twitch response that indicates hallucination. One case report described a patient who inadvertently combined trazodone and psilocybin and experienced potent antidepressant effects without psychedelic effects. These preliminary findings suggest that antidepressant benefits of psychedelics may be separable from hallucinatory effects, providing impetus for rigorous clinical trials in humans.

Real-World Effectiveness of Repeated Ketamine Infusions for Treatment-Resistant Bipolar Depression.

Focus (American Psychiatric Publishing) October 1, 2023 Farhan Fancy, Nelson B Rodrigues, Joshua D Di Vincenzo et al. 4 citations

Repeated intravenous ketamine infusions significantly reduced depression, suicidal thoughts, and anxiety in patients with treatment-resistant bipolar I/II depression, and improved functioning. In an observational study of 66 patients receiving four infusions over two weeks, depressive symptoms dropped by an average of 6.08 points on the QIDS-SR16 scale. Response rate was 35% and remission rate 20%. Hypomania occurred in only 4.5% of patients, with no mania or psychosis. The findings suggest real-world effectiveness and tolerability of IV ketamine for bipolar depression.