Frontiers in Psychiatry
October 18, 2021
A. Wilkowska, M. Wiglusz, M. Gałuszko-węgielnik et al.
35 citations
Anhedonia, a core symptom of depression linked to suicidality and reduced quality of life, often resists standard treatments. In 42 patients with treatment-resistant depression, eight ketamine infusions added to ongoing therapy significantly reduced anhedonia, as measured by the Snaith-Hamilton Pleasure Scale. This reduction in anhedonia appeared to mediate ketamine's overall antidepressant effect. However, the benefit was observed only among patients not using benzodiazepines. The findings require confirmation in a larger randomized placebo-controlled trial.
Neuropsychiatric Disease and Treatment
August 1, 2021
A. Wilkowska, A. Włodarczyk, M. Gałuszko-węgielnik et al.
33 citations
In an open-label observational study, 13 patients with treatment-resistant bipolar depression received eight intravenous infusions of 0.5 mg/kg ketamine over four weeks. After the seventh infusion, 61.5% responded and 46.2% achieved remission. Responders also showed a significant antisuicidal effect. Ketamine caused a transient rise in blood pressure and increased dissociative symptoms, but no manic switch or serious adverse events occurred. The findings suggest ketamine is a safe and feasible add-on treatment for this population.
Frontiers in Behavioral Neuroscience
June 23, 2021
A. Wilkowska, Ł. Szałach, W. Cubała
32 citations
Major depressive disorder is the leading cause of disability worldwide, and its pathophysiology remains incompletely understood. The gut microbiome, acting through the gut–microbiota–brain axis, is an increasingly recognized environmental factor in depression. Available treatments are insufficient, as 30% of patients are treatment-resistant, creating a need for novel strategies. Ketamine is an effective antidepressant in treatment-resistant patients, and its effects may be partially mediated by modification of gut microbiota. This review examines data on gut microbiota in depression, focusing on ketamine's effects on the microbiome in animal models. Earlier reports are preliminary and insufficient for firm conclusions, but further studies could clarify the gut–brain axis's role in depression treatment and lead to new strategies.