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.
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.
Journal of affective disorders
December 1, 2022
Anastasia Levinta, Shakila Meshkat, Roger S McIntyre et al.
Ketamine rapidly reduces depressive symptoms in people with treatment-resistant depression, but its effectiveness may diminish as the number of prior failed treatments increases. A systematic review of 18 randomized controlled trials found that ketamine and esketamine worked at both lower and higher stages of treatment resistance, yet effect sizes and duration of benefits were greater in studies involving patients with fewer prior antidepressant failures. Variability in how studies defined treatment resistance and measured outcomes prevented clear comparisons of efficacy across different resistance stages. The authors conclude that while ketamine remains broadly effective, more failed treatment trials may reduce its efficacy, and participant-level data are needed to clarify the relationship between resistance level and response.