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.
Pharmaceuticals
April 1, 2023
Aleksander Kwaśny, A. Włodarczyk, Damian Ogonowski et al.
27 citations
Ketamine reduces the severity of sleep insomnia in depression. Two studies reported significant improvement in sleep measured by MADRS and QIDS-SR16 scales after intravenous ketamine and intranasal esketamine. One case report showed mitigation of symptoms in PSQI and ISI during 3-month treatment with esketamine. Two studies with objective nocturnal EEG measurements showed a decrease in nocturnal wakefulness accompanied by an increase in slow wave and REM sleep. Robust data are lacking, and more research is needed.
Medicine
July 23, 2021
A. Włodarczyk, W. Cubała, M. Gałuszko-węgielnik et al.
23 citations
Intravenous ketamine as an add-on to standard medication shows a good safety profile in inpatients with treatment-resistant depression. In 49 patients with major depressive or bipolar disorder, dissociative symptoms measured by the Clinician-Administered Dissociative States Scale (CADSS) varied significantly across eight infusions, while psychomimetic symptoms measured by the Brief Psychiatric Rating Scale (BPRS) did not. Both scores returned to absent levels within one hour after each infusion. Neither dissociative nor psychomimetic scores were linked to treatment outcome. The study provides no support for a connection between dissociation and antidepressant response.
International Journal of Molecular Sciences
August 1, 2025
Ł. Szałach, Klaudia Ciesielska-Figlon, A. Daca et al.
7 citations
In people with treatment-resistant depression, a single intravenous dose of ketamine (0.5 mg/kg) produces rapid, temporary shifts in immune markers. Within 4 hours, total T cells and certain helper T-cell subsets increased, while by 24 hours, activated T cells declined and the ratio of helper to cytotoxic T cells decreased. Blood levels of the anti-inflammatory cytokine IL-10 rose, while the pro-inflammatory cytokines IL-6 and IL-8 fell—IL-8 remained lower for at least 24 hours. In laboratory experiments, high-dose ketamine boosted the growth of helper T cells from depressed patients and increased secretion of IL-8 and IL-6 from activated immune cells. The sustained drop in IL-8 points to an anti-inflammatory effect and may serve as a biomarker for treatment response.