Journal of Psychopharmacology
March 1, 2020
P. Glue, Shona Neehoff, A. Sabadel et al.
97 citations
In a double-blind, psychoactive-controlled study, 12 patients with treatment-resistant generalized anxiety and social anxiety disorders who were not currently depressed received ascending doses of ketamine (0.25, 0.5, 1 mg/kg) at weekly intervals, with midazolam 0.01 mg/kg randomly inserted as a control. Improvements in anxiety ratings occurred within an hour of ketamine dosing and persisted for up to one week. A dose-response profile was noted for anxiolytic effects, dissociative side effects, and changes in blood pressure and heart rate. Midazolam had minor brief effects on anxiety ratings. Ketamine was safe and well tolerated. Ketamine may be a potential therapeutic option for these patients.
British Journal of Psychiatry
July 14, 2023
Colleen Loo, N. Glozier, D. Barton et al.
70 citations
In a phase 3 trial across seven mood disorders centers in Australia and New Zealand, subcutaneous racemic ketamine was tested against midazolam for treatment-resistant depression. With flexible dosing (0.5–0.9 mg/kg), ketamine led to a 19.6% remission rate compared to 2.0% for midazolam, a significant difference. Fixed dosing (0.5 mg/kg) showed no difference. Acute side effects, such as psychotomimetic effects and blood pressure increases, resolved within two hours. The subcutaneous route proved practical and feasible.
Journal of clinical pharmacology
February 17, 2020
P. Glue, N. Medlicott, P. Surman et al.
44 citations
Oral controlled-release ketamine tablets improve safety and tolerability compared with injected ketamine by reducing peak drug exposures. In a randomized, placebo-controlled ascending-dose study of 24 healthy volunteers, doses of 60, 120, or 240 mg or placebo were given. Drug release occurred over about 10 hours, with most drug present as norketamine (approximately 90%). Elimination half-life was prolonged (7–9 hours) versus published data from immediate-release oral forms. No changes in blood pressure or heart rate occurred after any dose. Mild dissociation was reported only after 240 mg, with mean ratings of 1–2 out of 76. No clinically significant ECG or lab changes were observed. Reducing and delaying peak ketamine concentration improves tolerability for patients with depression or anxiety.
Therapeutic Advances in Psychopharmacology
January 1, 2020
P. Glue, N. Medlicott, Shona Neehoff et al.
43 citations
An extended-release oral ketamine tablet was tested in seven patients with treatment-resistant depression and anxiety who had previously responded to subcutaneous ketamine. Over 96 hours, all patients showed more than 50% improvement in mood ratings, with gradual reductions in anxiety and depression. The tablet was safe and well tolerated, with no changes in vital signs and only one brief report of dissociation. The ratio of norketamine to ketamine increased over time, suggesting ketamine may induce its own metabolism. Serum BDNF concentrations did not change. The findings suggest extended-release oral ketamine may improve safety and tolerability while offering a slightly delayed onset of mood improvement compared to injected forms.
BJPsych Open
October 13, 2023
B. Beaglehole, P. Glue, Mike Clarke et al.
9 citations
New Zealand clinicians developed practical guidelines for using ketamine to treat treatment-resistant major depressive disorder in publicly funded specialist mental health services. The guidelines offer two treatment pathways: a test of responsiveness with intramuscular ketamine followed by a 3-month course of oral ketamine, aiming to maximize short-term benefits. The guidance was created through consultation with senior leadership, clinical pharmacy, psychiatrists, nursing, service users, and Māori mental health workers.
Journal of Affective Disorders
December 1, 2017
Shona Neehoff, P. Glue
8 citations
Several possible explanations could account for the differing results observed in two assessments of the CADSS (Clinician-Administered Dissociative States Scale) performance.
Psychedelic Medicine
October 15, 2024
Thivya Turner, P. Glue
1 citation
In people with life-threatening illness, psychedelic-assisted therapy may reduce distress, depression, and anxiety by improving attitudes toward life, death, and spirituality. A systematic review of 14 studies found that symptom improvements were linked to reduced demoralization and hopelessness, greater death acceptance, increased optimism, a stronger sense of meaningful existence, and enhanced spirituality. Mixed results appeared for other life and death attitudes. The evidence is limited and of variable quality, so findings should be interpreted cautiously.