Journal of Affective Disorders
March 1, 2023
Debora de A. Simoes Moreira, Luís Eduardo Gauer, Guilherme Teixeira et al.
25 citations
A systematic review and meta-analysis of eight randomized controlled trials or cohort studies comparing ketamine with electroconvulsive therapy (ECT) for treatment-resistant depression found no evidence that ketamine is superior to ECT in reducing depressive symptom severity or in achieving response to therapy. Among side effects, patients treated with ketamine had a statistically significant lower risk of muscle pain compared with those receiving ECT. The analysis also noted trends toward more dissociative symptoms with ketamine and less nausea and headache, but these differences were not statistically significant. The authors caution that the small number of eligible studies, high heterogeneity, and risk of bias limit the strength of these conclusions.
CNS drugs
August 1, 2024
Liliana Patarroyo-Rodriguez, Stefanie Cavalcanti, Jennifer L Vande Voort et al.
13 citations
Anhedonia, the inability to feel pleasure, is a symptom that appears in many mental disorders beyond just depression and schizophrenia, and it is linked to worse outcomes such as higher suicide risk and poor treatment response. Although brain imaging and biomarkers have improved understanding, the neural basis of anhedonia is still not fully known. Ketamine, a fast-acting antidepressant, also seems to reduce anhedonia through a separate mechanism from its antidepressant effects. Other potential treatments are being explored, but many questions remain, highlighting the need for more research.
Journal of affective disorders
August 15, 2025
Stefanie Cavalcanti, Vanessa K Pazdernik, Jennifer L Vande Voort et al.
3 citations
Among adults with treatment-resistant depression receiving ketamine or esketamine, those reporting high perceived stress before treatment had lower odds of remission and needed more treatment sessions to achieve remission. In a cohort of 39 patients, 66.7% had high perceived stress. Each 5-point increase on the Perceived Stress Scale reduced the odds of remission by 60%, independent of baseline depression severity. Patients with high stress required a median of 3 treatments to reach remission versus 1 for those with low-to-moderate stress. The observational design and lack of a placebo group limit the findings.
The Journal of clinical psychiatry
January 21, 2026
Matheus G Marques, Aysegul Özerdem, Simon Kung et al.
1 citation
For treatment-resistant depression (TRD), a panel of 10 psychiatrists reached strong consensus on recommending augmentation with second-generation antipsychotics, transcranial magnetic stimulation, and ketamine/esketamine as next-step treatments after three failed antidepressant trials. Treatment preferences shifted to include nonaugmentative antidepressants and electroconvulsive therapy depending on patient characteristics such as metabolic disease and age. The findings underscore the importance of tailoring TRD treatment strategies to individual patient factors beyond conventional guideline tiers.