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Sagar V Parikh

University of Michigan, Ann Arbor, Michigan.

5 papers in the library · 34 citations · publishing 2024-2025

Papers

Change in neurocognitive functioning in patients with treatment-resistant depression with serial intravenous ketamine infusions: The Bio-K multicenter trial.

Psychiatry research May 1, 2024 Balwinder Singh, Sagar V Parikh, Jennifer L Vande Voort et al. 18 citations

In a nonrandomized, open-label clinical trial, 74 adults with treatment-resistant depression received three intravenous ketamine infusions, with an additional four infusions for those who remitted. After the acute phase, 53% (39/74) experienced remission of depression symptoms. Higher baseline language domain scores on the RBANS cognitive assessment were associated with greater odds of remission. No significant association was found between remission and baseline immediate or delayed memory, visuospatial, or attention scores. During the continuation phase, improvements in immediate and delayed memory and attention persisted, with additional gains in visuospatial and language domains. The findings suggest cognitive improvement, not deterioration, with serial ketamine administration.

Safe Ketamine Use and Pregnancy: A Nationwide Survey and Retrospective Review of Informed Consent, Counseling, and Testing Practices.

The Journal of clinical psychiatry August 26, 2024 Rachel M Pacilio, Juan F Lopez, Sagar V Parikh et al. 7 citations

Many women who could become pregnant receive ketamine for psychiatric conditions, but risks to a developing fetus are frequently overlooked. A survey of U.S. outpatient ketamine clinics found that fewer than half discuss pregnancy-related risks during informed consent, only 20% require pregnancy tests before treatment, and just 13.7% recommend or require contraception. A record review at one academic medical center showed all patients were tested weekly for pregnancy, but only half used contraception. The findings indicate a need for greater attention to reproductive health in ketamine treatment protocols.

Utilizing depression symptom-based phenotypes to explore ketamine treatment response in major depression: The Bio-K multicenter trial.

Journal of affective disorders September 15, 2025 Brandan K Penaluna, Jennifer L Vande Voort, William V Bobo et al. 4 citations

In people with treatment-resistant depression, intravenous ketamine improved symptoms across four depression subtypes: Sadness, Negative Thoughts, detachment/Interest and Activity, and Neurovegetative. After three infusions over 11 days, 53% of the 75 participants achieved remission. The Negative Thoughts subtype showed the least improvement, and the Neurovegetative subtype was the least responsive overall. Higher baseline Sadness scores were linked to lower remission rates, and a positive Sadness phenotype reduced the odds of remission (odds ratio 0.32). No meaningful sex differences in response were found by the end of treatment.

Outpatient Ketamine Prescribing Practices in Psychiatry in the United States: A Nationwide Survey Study.

The Journal of clinical psychiatry May 26, 2025 Rachel M Pacilio, Sagar V Parikh, Jamarie Geller 4 citations

Ketamine is increasingly used for psychiatric disorders outside academic settings, but little is known about real-world practices. A survey of U.S. community-based ketamine clinics and a review of their websites found that all clinics use ketamine for treatment-resistant depression, and many also prescribe it for treatment-naive depression (72.3%), bipolar depression (78.9%), and subclinical depression (59.7%). Over 80% of clinics offer maintenance treatment, often for prolonged periods, and over 40% provide ketamine for at-home use. Fewer than 30% of clinics are run by psychiatric physicians, and over 25% by nonphysician providers. The findings indicate significant variability in indications, duration, formulations, and settings, highlighting a need for increased oversight and specific practice guidelines.

High Baseline Plasma Anthranilic Acid Predicts Remission Upon Acute-Series Ketamine Infusion for Treatment-Resistant Depression.

Biological psychiatry global open science July 1, 2025 Stephen A Murata, Zachary B Madaj, Colt D Capan et al. 1 citation

Higher baseline levels of anthranilic acid (AA), a metabolite in the kynurenine pathway, predicted remission in patients with treatment-resistant depression receiving intravenous ketamine. In an open-label trial of 74 patients, 52% achieved remission after three infusions. Composite ratios of AA to intercellular adhesion molecule-1 and AA to tryptophan improved predictive accuracy over AA alone. The findings suggest that immunometabolic biomarkers could guide personalized ketamine treatment.