Journal of Psychiatric Research
May 1, 2022
Yazen Alnefeesi, D. Chen-Li, Ella Krane et al.
177 citations
Ketamine shows substantial real-world antidepressant effects in treatment-resistant depression, with about 45% of patients responding and 30% achieving remission, based on a systematic review and meta-analysis of 79 studies involving 2665 patients. The effect varies considerably among individuals; more treatment-resistant cases remit less often, but response rates do not differ. The therapeutic benefit does not significantly decline with repeated treatments, indicating that even the most treatment-resistant patients may benefit and that mid-to-long term treatment is effective for many.
Journal of Psychiatric Research
May 1, 2022
Tuyen T. Le, Isabel Pazos Cordero, Muhammad Youshay Jawad et al.
82 citations
Ketamine and its enantiomers show different abuse liability. Preclinical evidence indicates that (R,S)-ketamine and (S)-ketamine carry greater risk for abuse than (R)-ketamine, which at antidepressant-relevant doses in rodents appears safe with minimal liability. In clinical settings, limited studies suggest that single or repeated ketamine administrations under professional control did not lead to misuse, dependence, diversion, or gateway activity in patients with treatment-resistant depression. However, most clinical studies were retrospective and lacked systematic evaluation with validated scales. The review identified 65 eligible studies (55 preclinical, 10 clinical), with only 4 preclinical studies evaluating enantiomer abuse liability.
Brain sciences
June 4, 2023
Muhammad Youshay Jawad, Saleha Qasim, Menglu Ni et al.
46 citations
Ketamine shows promise as a treatment for bipolar depression, though evidence remains weak. A scoping review of 10 clinical studies (5 randomized controlled trials and 5 open-label studies) found that ketamine was generally tolerable, with minimal risk of triggering manic or hypomanic episodes, and demonstrated some effectiveness in reducing depressive symptoms and suicidality. The treatment may be particularly useful for patients with treatment-resistant bipolar depression. However, more research is needed to establish ketamine's role in both acute and maintenance treatment phases, and to study its potential for preventing recurrence and suicidal behavior.
Neuropharmacology
November 1, 2022
Muhammad Youshay Jawad, Joshua D. Di Vincenzo, Sebastian Badulescu et al.
29 citations
Ketamine is an effective rapid-acting antidepressant, but most research has focused on overall depression severity rather than specific symptom domains. This narrative review synthesizes evidence on ketamine's effects on cognition, anhedonia, suicidality, and psychosocial functionality. The strongest evidence supports ketamine's ability to reduce suicidality, and its rapid action may help prevent suicide. Evidence for other domains is weak, largely because few robust studies have assessed them as primary outcomes. The authors call for future research to examine ketamine's effects on specific depression domains to optimize treatment.
Expert Opinion on Drug Safety
April 6, 2022
Muhammad Youshay Jawad, Joshua D. Di Vincenzo, Felicia Ceban et al.
29 citations
Intranasal esketamine, when added to an oral antidepressant, is safe and more effective than a placebo nasal spray at reducing depressive symptoms in people with treatment-resistant depression and depression with suicidal thoughts or behavior. Pooling data from seven randomized controlled trials showed a small but significant improvement in depressive symptoms, with higher rates of response and remission. Year-long studies found lower relapse rates and no major long-term side effects. The treatment appears well tolerated and rapidly effective for these difficult-to-treat populations.
Expert Opinion on Drug Safety
April 15, 2022
Marcus A. Doyle, Susan Ling, Leanna M.W. Lui et al.
24 citations
Hallucinogen persisting perception disorder (HPPD) is an uncommon but serious condition in which individuals repeatedly experience hallucinations and perceptual disturbances after prior hallucinogen use. As some hallucinogens are being developed to treat mental disorders, understanding HPPD becomes more important. A scoping review of the literature up to July 2021 covered treatments, prevalence, risk factors, and pathophysiology of HPPD. The renewed interest in psychedelics as potential treatments highlights the need to better characterize HPPD's frequency, risk and protective factors, key features, and clinical factors.
Annals of Clinical Psychiatry
November 1, 2022
David Chen‐li, Leanna M.W. Lui, Joshua D. Rosenblat et al.
22 citations
Postpartum depression (PPD) is a severe mood disorder affecting mothers and children, and there is a need for rapid-acting treatments. This narrative review examined the available literature on ketamine for PPD, searching databases for preclinical studies, clinical trials, and reviews. Four clinical trials were identified. The review suggests that ketamine may be a favorable option due to its antidepressant and analgesic effects, short infusion time, and rapid clearance from the mother's bloodstream. However, evidence is insufficient to support its routine use, highlighting the need for more clinical research.
The primary care companion for CNS disorders
May 23, 2023
Saleha Qasim, Zaofashan Zaheer, Muhammad Youshay Jawad et al.
2 citations
A systematic review of five neuroimaging studies found that psilocybin therapy transiently increases global connectivity in major neural tracts and activates specific brain areas, and these changes are associated with antidepressant response in depressed patients. The pattern of functional brain changes resembles a 'brain reset' phenomenon and may serve as a predictor of psilocybin's antidepressant effects. Four of the studies were open-label, and one combined an open-label design with a randomized controlled trial. Three studies included psilocybin-assisted psychotherapy, and participants in most studies had treatment-resistant depression.