Psychopharmacology bulletin
April 8, 2025
Keming Gao, Buket Koparal, Evrim Bayrak Oruc et al.
99 citations
A patient with treatment-resistant depression and multiple comorbid conditions (generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder) experienced some short-term benefit from electroconvulsive therapy and ketamine infusion. Over a ten-year period from adolescence to adulthood, she had two separate periods of two-year stability, first with compounded ketamine intranasal spray and later with intranasal esketamine. She has been relatively stable without hospitalization or suicide attempt for more than two years on esketamine, suggesting that patients with complex treatment-resistant depression may benefit from ketamine-based treatments at different developmental stages.
Medicina (Kaunas, Lithuania)
March 21, 2025
Keming Gao, Evrim Bayrak Oruc, Buket Koparal
9 citations
Monoamine-based antidepressants, including SSRIs, SNRIs, bupropion, TCAs, mirtazapine, and agomelatine, show similar efficacy relative to placebo but differ in acceptability. The STAR*D study found sertraline, venlafaxine, and bupropion equally effective after citalopram failure. Dextromethorphan-bupropion, ketamine, and esketamine act faster but with effect sizes similar to monoamine drugs. Brexanolone and zuranolone are effective for postpartum depression, though zuranolone's effect in major depressive disorder is very small. Psychedelics show rapid, large, and durable effects but await phase III confirmation. NMDA receptor antagonists and neurosteroids may gain importance, while monoamine-based drugs likely remain mainstream.
Psychiatric services (Washington, D.C.)
June 25, 2025
Michael Liu, Rachel Branning, Austin Lee et al.
2 citations
Non-Hispanic Black, Hispanic, and Asian patients with moderate-to-severe recurrent major depressive disorder received ketamine at lower rates than non-Hispanic White patients. Esketamine was used less often among Black patients, more often among Hispanic patients, and at similar rates among Asian patients compared with White patients. Black and White patients who received either treatment had more co-occurring medical and psychiatric conditions than those who did not. The findings indicate significant racial-ethnic disparities in access to these advanced therapies, especially for Black patients.
Medicina (Kaunas, Lithuania)
June 3, 2024
Keming Gao
1 citation
A patient with treatment-resistant bipolar depression who had limited benefit from electroconvulsive therapy (stopped due to memory concerns) and ketamine infusion (tolerated but little benefit) responded well to deep repetitive transcranial magnetic stimulation (dTMS). After 39 sessions of dTMS, the patient maintained relative stability for more than 2 years. This case suggests that dTMS may benefit patients with treatment-resistant bipolar depression who have not responded to or cannot continue ECT or ketamine infusion.
Psychopharmacology bulletin
June 5, 2026
Keming Gao, Evrim Bayrak Oruc, Heather Wobbe et al.
Among six patients with bipolar depression who received both electroconvulsive therapy (ECT) and ketamine infusion (KET-IFU) in routine care, most responded well to ECT, with four showing at least 50% improvement on a depression self-report scale. Half of those who responded to ECT also responded to KET-IFU, though the onset of antidepressant effect differed between treatments. One patient did not respond to either treatment. Subjective memory concerns led five patients to try KET-IFU after ECT, though their cognitive test scores were normal. No patient stopped KET-IFU due to side effects. The findings suggest that some patients with bipolar depression may benefit similarly from both treatments, but head-to-head randomized studies are needed.