Journal of Affective Disorders
May 1, 2019
Wei Zheng, Xiaohong Li, Xiao-Min Zhu et al.
57 citations
An updated meta-analysis of 17 randomized controlled trials involving 1,035 people with major depressive disorder found that adding ketamine alone to electroconvulsive therapy does not improve depressive symptoms compared with other anesthetic agents at any time point. Combining ketamine with other anesthetics showed a short-term advantage in reducing depressive symptoms early in treatment, but this benefit did not persist after the full course of ECT or at the end of the study. Most subgroup analyses confirmed the lack of significant effect. Ketamine alone increased blood pressure more than other anesthetics. Results for neurocognitive function were mixed.
Frontiers in Psychiatry
September 23, 2024
Zhan-Ming Shi, Yu-Ping Ning, Xin-Hu Yang et al.
21 citations
A systematic review of five randomized controlled trials involving 472 adults with major depressive disorder found that psilocybin improved depressive symptoms in three of the five studies and reduced anxiety symptoms in four of the five studies compared to controls. Suicidal ideation improved in only one trial. Discontinuation rates were similar between psilocybin (2–13%) and control groups (4–21%). The most common adverse drug reaction in both groups was headache. The authors conclude that psilocybin is effective for depressive and anxiety symptoms but note that long-term efficacy and safety require further investigation in larger trials.
Journal of affective disorders
January 1, 2025
Qing-Bin Zeng, De-Cheng Zou, Xing-Bing Huang et al.
12 citations
For people with treatment-resistant depression, electroconvulsive therapy (ECT) is a common option. Esketamine, a fast-acting antidepressant, had not been tested as an anesthetic for ECT. In a double-blind randomized trial, 40 patients received either esketamine or propofol anesthesia for eight ECT sessions. Esketamine-ECT was non-inferior to propofol-ECT for reducing depressive symptoms after eight sessions. Response rates were 80% for esketamine versus 70% for propofol, and remission rates were 65% versus 55%, but non-inferiority was not confirmed for these outcomes. Cognitive function was similar between groups. Results for anxiety, suicidal ideation, and adverse events were inconclusive. Larger replication studies are needed.
Journal of affective disorders
February 15, 2025
Zhan-Ming Shi, Xian-Jun Lan, Qing Chen et al.
6 citations
A meta-analysis of five randomized controlled trials involving 664 patients with major depressive disorder or bipolar depression found that intravenous (IV) ketamine produced a greater reduction in depressive symptoms 24 hours after the first treatment compared to electroconvulsive therapy (ECT). However, by the end of treatment, both approaches showed similar rates of response and remission. Neurocognitive outcomes were inconsistent across studies. IV ketamine caused more dissociation, blurred vision, dizziness, and double vision, while ECT led to more muscle pain. The faster onset of antidepressant effects with IV ketamine does not translate into superior long-term outcomes, and larger trials are needed to assess lasting efficacy and safety.
Translational psychiatry
August 6, 2024
Chengyu Wang, Xiaofeng Lan, Weijian Liu et al.
6 citations
Non-improvement after four ketamine infusions, or three consecutive non-improvements after three infusions, reliably predicts overall non-response to a six-dose course of intravenous ketamine for depression. Among 135 individuals with major depressive or bipolar disorder in a current depressive episode, sensitivities for predicting non-response exceeded 90% using these early non-improvement criteria. Those who did not improve by these points showed no significant reduction in depressive symptoms from subsequent infusions. The findings suggest that early non-improvement can guide clinicians to discontinue treatment, avoiding ineffective continued dosing.
Frontiers in Psychiatry
December 22, 2022
Wei Zheng, Xin-Hu Yang, Li-Mei Gu et al.
4 citations
After six intravenous injections of 0.5 mg/kg ketamine, both patients with melancholic depression (30 individuals) and those with non-melancholic depression (105 individuals) showed similar improvement in anhedonic symptoms. The antianhedonic response rate was 43.3% in the melancholic group versus 50.5% in the non-melancholic group, a difference that was not statistically significant. Remission rates were also similar: 20.0% and 21.0%, respectively. By day 26, the melancholic group had significantly lower anhedonia scores on the Montgomery–Åsberg Depression Rating Scale compared to the non-melancholic group. Ketamine appears equally effective for reducing anhedonia in both melancholic and non-melancholic depression.
Frontiers in psychiatry
January 1, 2025
Jian-Qiang Tan, Li-Mei Gu, Yan-Ling Zhou et al.
2 citations
Patients with depression and a higher baseline body mass index (BMI) experienced greater reductions in depressive symptoms after six intravenous ketamine infusions compared with those with a lower baseline BMI. In a study of 135 patients (103 with major depressive disorder, 32 with bipolar depression), those with a lower BMI (under 26) showed a significantly higher response rate after the first infusion (40.3% vs. 23.6%), but this difference disappeared by the sixth infusion. The overall change in depression scores over time differed significantly between the groups, with the higher-BMI group showing greater improvement. The findings are from an exploratory, post-hoc analysis of an open-label, single-arm trial.
Current neuropharmacology
January 1, 2025
Wei Zheng, Limei Gu, Jianqiang Tan et al.
1 citation
Repeated intravenous ketamine infusions rapidly reduce anhedonia in both younger and older adults with major depressive episodes, but older patients show a weaker response. In a study of 135 patients (116 younger, 19 older) receiving six ketamine infusions over 12 days, anhedonia scores dropped significantly in both age groups within 4 hours of the first infusion, with effects maintained throughout treatment. By day 26, younger patients had lower anhedonia scores than older patients. The antianhedonic response rate was 51.7% in younger patients versus 31.6% in older patients, and remission occurred in 24.1% of younger patients but none of the older patients.
Frontiers in psychiatry
January 1, 2025
Zhan-Ming Shi, Xing-Bing Huang, Yan-Ling Zhou et al.
1 citation
China's National Health Commission prioritizes early diagnosis and standardized treatment of major depressive disorder (MDD). Rapid treatment centers across the country use electroconvulsive therapy (ECT), intravenous ketamine/esketamine, esketamine nasal spray, magnetic seizure therapy (MST), and Stanford Neuromodulation Therapy (SNT). This policy and practice review examines the strengths and shortcomings of these techniques in China, noting their potential to accelerate recovery. The findings offer insights for other countries and regions adopting rapid antidepressant strategies.