Journal of Neurological Sciences
January 1, 2022
Subha Subramanian, S. Haroutounian, B. Palanca et al.
58 citations
Ketamine, an anesthetic and NMDA receptor antagonist, is used to treat chronic pain and depression, conditions that often co-occur and may share neural pathways. Intravenous and intranasal ketamine are both effective for acute depressive episodes, with intravenous administration having higher bioavailability and providing better post-operative pain relief while reducing opioid use. Few studies have addressed ketamine's effects on concurrent depression and pain. Larger randomized controlled trials are needed to compare the safety and efficacy of intravenous versus intranasal ketamine, identify ideal target populations, and determine optimal dosing for treating both conditions.
Psychopharmacology
January 22, 2021
J. Siegel, B. Palanca, B. Ances et al.
53 citations
A single 96-hour infusion of ketamine, co-administered with clonidine, is well tolerated and produces a rapid and sustained antidepressant response in over 50% of adults with treatment-resistant depression. In an open-label study of 23 adults, depressive symptoms dropped markedly from an average MADRS score of 29 at baseline to 9 one day after infusion, and remained reduced at 2 weeks (13) and 8 weeks (15). Brain imaging showed that the infusion normalized overconnectivity in the limbic system and between the subgenual anterior cingulate cortex and the default mode network, with response-dependent and treatment-dependent connectivity changes.
The American journal of geriatric psychiatry
December 1, 2022
H. Oughli, M. A. Gebara, A. Ciarleglio et al.
33 citations
Repeated intravenous ketamine infusions are well-tolerated and associated with improvements in depression and executive function in older adults aged 60 and older with treatment-resistant depression. In a pilot trial, 25 participants received ketamine twice weekly for four weeks, with partial responders continuing weekly infusions for four more weeks. Completion rates were high (88% acute, 100% continuation), with no serious adverse events or discontinuations due to side effects. Transient blood pressure elevation, dissociation, and craving occurred but were manageable. Depressive symptoms improved significantly, with 48% of participants responding. Executive function and overall fluid cognition also improved (Cohen's d = 0.61) and were sustained.
International Journal of Geriatric Psychiatry
July 1, 2023
Benjamin Vanderschelden, M. A. Gebara, H. Oughli et al.
13 citations
Among older adults with treatment-resistant depression, intravenous ketamine treatment was associated with improvements in psychological well-being and sleep, but not in suicidality. The findings suggest that ketamine may enhance aspects of mental health beyond depressive symptoms in this population, though its effect on suicidal thoughts remains unclear.