Asian journal of psychiatry
September 1, 2024
Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny
8 citations
In patients with treatment-resistant bipolar depression receiving eight intravenous ketamine infusions while continuing their usual medications, the most common new symptoms that appeared included decreased appetite, weight gain, excessive sleep, and mood changes that varied throughout the day. Feelings of sadness, hopelessness about the future, reduced sexual interest, and physical discomfort did not emerge. However, 13.6% of patients reported new thoughts of death or suicide. Larger studies using both clinician and patient reports are needed to better understand these treatment-emergent symptoms, and clearer definitions would improve future research.
Neuropsychopharmacology Reports
July 20, 2025
Zofia Kachlik, Wiesław Jerzy Cubała, Michał Walaszek et al.
3 citations
Ketamine is a fast-acting antidepressant for treatment-resistant bipolar depression, but about 40% of patients do not respond. Among 35 patients receiving a four-week ketamine regimen, nonresponders had more psychiatric comorbidities (median 2 vs. 1) and were more likely to have any psychiatric comorbidity (78.6% vs. 33.3%) and prior benzodiazepine use (64.3% vs. 23.8%). Individual comorbidities and baseline suicidality were not linked to response. Ketamine remains safe and well-tolerated for short-term use, but a heavier comorbidity burden and benzodiazepine use may predict nonresponse.
Pharmacological reports : PR
April 30, 2025
Michał Walaszek, Wiesław Jerzy Cubała, Zofia Kachlik et al.
3 citations
Among inpatients with treatment-resistant depression receiving ketamine over four weeks, 75% did not respond. Non-responders had lower rates of prior substance use disorder (53.3% vs. 100%) and fewer psychiatric comorbidities. The findings suggest that a higher burden of traditional risk factors for treatment-resistant depression may not limit ketamine's effectiveness and could even enhance response compared to 'pure' major depressive disorder. Early identification of potential non-responders could optimize treatment decisions and reduce ineffective exposure.
Drugs - real world outcomes
December 1, 2024
Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny
3 citations
After a course of ketamine infusions, many patients with bipolar depression still experience residual symptoms, even when their overall depression scores improve. In a real-world analysis of 22 patients receiving ketamine while continuing their usual medications, 14 responded to treatment. The most common lingering symptoms were sad mood (85.7% of responders), a pessimistic view of the future (78.6%), difficulty falling asleep, and low physical energy (both 71.4%). Difficulty falling asleep and sad mood were also rated as the most severe. These findings highlight that functional recovery may require targeting specific residual symptoms beyond overall mood improvement.
Journal of affective disorders
August 15, 2026
Michał Walaszek, Wiesław Jerzy Cubała, Zofia Kachlik et al.
Anhedonia, a core symptom of major depressive disorder linked to poor outcomes, may be reduced by ketamine. In a retrospective analysis of 34 inpatients with treatment-resistant depression receiving short-term ketamine as an add-on to standard care, 16 patients (47.1%) did not respond to treatment, defined as less than a 50% reduction on the Snaith-Hamilton Pleasure Scale. Non-responders were more likely to be single, had fewer lifetime depressive episodes, and lower rates of prior substance use disorder. These factors suggest that psychosocial and demographic characteristics influence anhedonia treatment outcomes, supporting a personalized approach to mood disorder treatment.
Therapeutic advances in psychopharmacology
January 1, 2026
Zofia Kachlik, Wiesław Jerzy Cubała, Michał Walaszek et al.
Anhedonia, a core symptom of bipolar depression, often fails to improve with ketamine treatment in patients with treatment-resistant bipolar depression. In a retrospective analysis of 31 patients who received eight doses of ketamine, 45.2% did not achieve a 50% or greater reduction in anhedonia scores. Nonresponders tended to have higher body mass index, later illness onset, fewer hypomanic episodes, and lower employment rates. These metabolic, illness-course, and psychosocial factors may help predict which patients are less likely to benefit from ketamine's anti-anhedonic effects.