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Farhan Fancy

Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Centre, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

6 papers in the library · 258 citations · publishing 2023

Papers

Psilocybin-assisted therapy for depression: A systematic review and meta-analysis.

Psychiatry research November 1, 2023 Sipan Haikazian, David C J Chen-Li, Danica E Johnson et al. 121 citations

A systematic review and meta-analysis of 13 studies (686 participants) found that psilocybin therapy produced a large reduction in depressive symptoms compared to control conditions, with a standardized mean difference of -0.78. Response and remission rates were also significantly higher with psilocybin. Open-label trials showed robust decreases in depression after psilocybin administration. The findings suggest antidepressant efficacy for psilocybin-assisted psychotherapy, but the authors note that further studies are needed to confirm safety and efficacy and to optimize treatment protocols.

Oral ketamine for depression: An updated systematic review

World Journal of Biological Psychiatry January 18, 2023 Shakila Meshkat, Sipan Haikazian, Joshua D. Di Vincenzo et al. 61 citations

Oral ketamine shows potential as an antidepressant for unipolar and bipolar depression, based on a systematic review of 22 studies involving 2336 patients. All included studies reported significant improvement after ketamine administration, and it was well tolerated without serious adverse events. However, the review identified important limitations, including a small number of randomized clinical trials (only four) and a high risk of bias in those trials due to analysis methods and adverse events monitoring. Ketamine dosages ranged from 0.5 to 1.25 mg/kg, with administration frequency from daily to monthly. Further research with larger samples and longer follow-up is needed to determine its antisuicidal effect and efficacy in treatment-resistant depression.

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.

Ketamine for bipolar depression: an updated systematic review

Therapeutic Advances in Psychopharmacology January 1, 2023 Farhan Fancy, Sipan Haikazian, Danica E. Johnson et al. 23 citations

Ketamine given intravenously at subanesthetic doses (0.5–0.75 mg/kg) or as esketamine (28–84 mg) appears safe and effective as an add-on treatment for bipolar depression when combined with a mood stabilizer. Across eight studies (235 participants), 48% of those receiving ketamine achieved at least a 50% reduction in depression severity, compared with 5% on placebo. Real-world response rates were lower (30%) than in clinical trials (63%). Some studies noted reductions in suicidal ideation, though not all findings were statistically significant. Ketamine was generally well tolerated, but 2% of participants (five receiving ketamine) developed hypomanic or manic symptoms, and significant dissociative effects occurred at 40 minutes in some trials.

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.

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.