Journal of Affective Disorders
September 23, 2020
A. Bahji, G. Vázquez, C. Zarate
404 citations
A systematic review and meta-analysis of 24 randomized controlled trials with 1,877 participants compared racemic ketamine and esketamine for unipolar and bipolar major depression. Racemic ketamine showed greater treatment response (rate ratio 3.01 versus 1.38) and remission rates (rate ratio 3.70 versus 1.47) than esketamine, and had lower dropout rates (rate ratio 0.76 versus 1.37). Intravenous ketamine appears more efficacious than intranasal esketamine for depression.
Progress in Neuro-psychopharmacology and Biological Psychiatry
January 1, 2020
A. Bahji, Ashleigh Forsyth, D. Groll et al.
85 citations
MDMA-assisted psychotherapy shows promise as a safe and effective treatment for chronic, treatment-refractory posttraumatic stress disorder (PTSD). A systematic review and meta-analysis of five randomized trials involving 106 participants (average age 35–40 years, 70% female) found that MDMA-assisted psychotherapy produced a high rate of clinical response and remission, with a large effect size in reducing PTSD symptoms. The treatment was well-tolerated, with few serious adverse events. However, larger studies with longer follow-up are needed to confirm these findings.
International Journal of Neuropsychopharmacology
April 30, 2021
A. Bahji, C. Zarate, G. Vázquez
62 citations
Ketamine appears to help treat bipolar depression, though evidence is preliminary. A systematic review of six studies involving 135 adults (53% female, average age 44.7 years) found that 61% of those receiving intravenous racemic ketamine (0.5 mg/kg, added to a mood stabilizer) achieved at least a 50% reduction in depression severity, compared to 5% receiving placebo. Response rates across studies ranged from 52% to 80%. Ketamine was reasonably well tolerated, but two participants developed manic symptoms (one on ketamine, one on placebo), and some experienced significant dissociative symptoms 40 minutes after infusion in two trials. Longer-term outcomes and alternative formulations need further study.