Asian journal of psychiatry
July 1, 2024
Muhammad Anas Nayyer, Suchna Meeral Khan, Mohammad Umer et al.
14 citations
A meta-analysis of seven randomized controlled trials examined whether esketamine given around childbirth can prevent postpartum depression (PPD). The analysis found a lower incidence of PPD in women who received esketamine compared to a control group, both in the first week (risk ratio 0.37) and at 4–6 weeks postpartum (risk ratio 0.48). Edinburgh Postnatal Depression Scale scores were significantly lower in the esketamine group during the first week (mean difference -1.23) but not after 4 weeks (mean difference -0.10). Hallucination was significantly more common with esketamine (risk ratio 13.85), while other side effects like dizziness, nausea, and headache did not differ significantly.
Asian journal of psychiatry
June 1, 2025
Mingrui Chen, Jingyan Jin, Hongsheng Bi et al.
12 citations
NMDA receptors, a type of glutamate receptor, are central to neuroplasticity and are implicated in depression, where their dysfunction can cause neuronal damage and disrupt brain adaptability. Ketamine, an NMDA receptor antagonist, rapidly alleviates severe depression and suicidal thoughts within hours by reducing NMDA receptor activity and activating the mTOR pathway, but its use is limited by side effects like hallucinations and dependency. Esketamine, an FDA-approved variant, offers improved efficacy and fewer side effects. Other NMDA-modulating compounds, including memantine and rapastinel, are under investigation. Future research should focus on NMDA receptor molecular mechanisms to develop safer, more effective, and personalized depression treatments with longer-lasting effects.
Asian journal of psychiatry
September 1, 2024
Pn Suresh Kumar, Vikas Menon, Chittaranjan Andrade
12 citations
In outpatients with treatment-resistant depression, oral ketamine was better tolerated than intravenous (IV) ketamine, with a lower dropout rate (26.7% vs 54.8%). Depression ratings and response and remission rates did not differ between the two groups at day 14 or day 30. Adverse events such as headache (56.7% vs 74.2%) and drowsiness (0.0% vs 22.6%) were less common with oral ketamine. However, conclusions about relative antidepressant efficacy cannot be drawn due to the high dropout rate in the IV group.
Asian journal of psychiatry
June 1, 2024
Adam Włodarczyk, Jakub Słupski, Joanna Szarmach et al.
12 citations
A year-long follow-up of three adults with treatment-resistant depression who received a single intravenous dose of arketamine (R-ketamine) found substantial symptom reduction and improved social and vocational functioning, including reduced sick leave and hospitalizations. One participant developed a substance use disorder, highlighting the need for careful monitoring. The findings suggest arketamine may offer a transformative approach to managing depression, with fewer dissociative side effects and lower abuse potential than esketamine, but the small sample size and lack of randomization require cautious interpretation.
Asian journal of psychiatry
February 1, 2024
Matcheri S Keshavan, Hemant Bhargav
12 citations
Ancient Eastern philosophies, including Vedic, Upanishadic, and Buddhist traditions, have long argued that the individual self is illusory, proposing either a no-self or a universal Self, and that the perceived universe is an illusion (Maya) with only the knower (Brahman) as real—a view that resonates with modern quantum theory. In contrast, Western philosophy, shaped by Cartesian dualism, has pursued an individualist view of the self. Recent psychological research converges with Eastern perspectives, highlighting the role of self-understanding, metacognition, and mindfulness in addressing mental afflictions. Several contemporary Western psychotherapeutic models reflect these ancient insights, but further empirical testing and development of such approaches are needed.
Asian journal of psychiatry
June 1, 2025
Vern Chie Hue, Yan-Li Siaw, Azmawaty Mohamad Nor
11 citations
A systematic review and meta-analysis of nine studies found that Mindfulness-Based Stress Reduction (MBSR) consistently reduces anxiety and improves emotional regulation and coping skills in people aged 13 to 26 with anxiety disorders. The evidence, following PRISMA guidelines, indicates MBSR is an effective therapeutic tool for managing anxiety in this age group, with benefits for long-term anxiety management. The review highlights the need for practitioners to incorporate MBSR into clinical practice.
Asian journal of psychiatry
April 1, 2025
Asif Seraj, Mohammed Reyazuddin, R K Gaur et al.
11 citations
A single oral dose of racemic ketamine (3 mg/kg) reduced suicidal ideation and depression symptoms more than an active placebo (oral midazolam, 0.3 mg/kg) in adults with major depressive disorder. Suicidal ideation scores were lower in the ketamine group at 4 hours, day 3, and day 7; depression scores were lower at 4 hours and day 3. By day 7, 25% of ketamine-treated patients responded to treatment (vs. 0% with midazolam), and 5% achieved remission (vs. 0%). Side effects such as nausea, emotional disturbance, and depersonalization were more common with ketamine but not treatment-limiting. Oral racemic ketamine appears reasonably well-tolerated and rapidly effective for suicidal ideation and depression.
Asian journal of psychiatry
November 1, 2024
Zifan Zhen, Xueqiang Sun, Shiying Yuan et al.
8 citations
A review of hallucinogens, MDMA, and ketamine for severe mental health disorders describes their mechanisms and clinical outcomes. Hallucinogens like LSD and psilocybin target 5-HT2A receptors, inducing perceptual shifts that aid therapy for depression and anxiety. MDMA influences serotonin, dopamine, and norepinephrine, alleviating PTSD symptoms by enhancing emotional engagement during psychotherapy. Ketamine, a glutamate receptor antagonist, rapidly relieves symptoms in treatment-resistant depression. These substances show promise for patients unresponsive to traditional treatments but require careful dosage, monitoring, and risk management to prevent abuse and adverse effects.
Asian journal of psychiatry
September 1, 2024
Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny
8 citations
In patients with treatment-resistant bipolar depression receiving eight intravenous ketamine infusions while continuing their usual medications, the most common new symptoms that appeared included decreased appetite, weight gain, excessive sleep, and mood changes that varied throughout the day. Feelings of sadness, hopelessness about the future, reduced sexual interest, and physical discomfort did not emerge. However, 13.6% of patients reported new thoughts of death or suicide. Larger studies using both clinician and patient reports are needed to better understand these treatment-emergent symptoms, and clearer definitions would improve future research.
Asian journal of psychiatry
January 1, 2025
Christopher Peter, Satish Suhas, Guru S Gowda et al.
6 citations
Acute agitation occurs in 2.6% of emergency cases and up to 12.2% among patients with schizophrenia or bipolar disorder. Ketamine, given by injection, provides rapid sedation, with an average onset of 6.1 minutes. In a systematic review of 29 studies involving 1516 patients (mean age 35.5, 67.9% male), most received intramuscular ketamine at a mean dose of 3.83 mg/kg. However, 24.5% needed additional doses or rescue medications. Adverse effects included tachycardia (5.1%), hypertension (5.5%), hypersalivation (5.6%), and rare cardiac arrest (0.2%). Intubation occurred in 19.1%, but this could not be attributed solely to ketamine. No evidence showed worsening of psychotic symptoms.
Asian journal of psychiatry
October 1, 2024
An-Nie Chung, Ming-Chyi Huang, Tung-Hsia Liu et al.
5 citations
People who develop persistent psychosis from heavy, chronic ketamine use show the highest blood levels of neurofilament light chain (NFL), a marker of nerve cell damage, compared to ketamine users without persistent psychosis, people with schizophrenia, and healthy controls. NFL levels averaged 24.5 pg/mL in ketamine users with persistent psychosis, 12.9 pg/mL in those without, 9.2 pg/mL in schizophrenia patients, and 6.2 pg/mL in controls. Ketamine dependence was linked to higher NFL than schizophrenia, and the elevated NFL in those with persistent psychosis suggests a distinct neurobiological basis for this condition, even though its symptoms resemble schizophrenia.
Asian journal of psychiatry
June 26, 2025
Adi Sulstarova, Luise Scheuerlein, Silvia Monari et al.
4 citations
Psychedelic-induced psychosis is rare, occurring in less than 1% of users in controlled trials, but evidence on its treatment is limited. A systematic review of 93 cases from 1955 to 2024 found that LSD (47.3%) and MDMA (38.7%) were the most common substances involved, with an average patient age of 23.7 years and 88% male. Psychosis lasted about 1.8 weeks on average. Second-generation antipsychotics had a response rate of 91.3%, significantly higher than first-generation antipsychotics at 27%. Electroconvulsive therapy also showed a 91% response rate. Follow-up revealed 34% of patients later developed schizophrenia spectrum disorders and 20.4% bipolar disorder, though limited follow-up data constrain these findings.
Asian journal of psychiatry
June 1, 2025
Matcheri S Keshavan, Hemant Bhargav
4 citations
Eastern spiritual traditions, including Hindu and other ancient practices, offer pathways to well-being through self-awareness (knowledge), selfless action (karma yoga), and compassion (bhakti yoga). Yogic meditative practices (dhyana yoga) combine ethical behavior, postures, breath control, and meditation to master physiological and psychological processes. These practices require sustained effort (abhyasa) and detachment (vairagya) to overcome ego hindrances. The paper reviews these concepts and connects them to modern psychology and neuroscience, noting that focused attention, open-monitoring, and transcendental meditation show somewhat distinctive neural correlates with brain oscillations and circuits. These approaches may be differentially effective across medical and psychiatric disorders. Gaps in knowledge are identified, and a framework for future research in positive psychology and psychiatry is proposed.
Asian journal of psychiatry
April 1, 2025
Nathan Menke, Elizabeth Hoffman, Kelsey Gaylor et al.
4 citations
Ketamine's unique properties—including its safety, modulation of multiple neurotransmitter systems, and ability to promote neuroplastic changes—make it promising for neuropsychiatric disorders beyond anesthesia. This overview discusses its emerging uses in treating substance use disorders (alcohol, cannabis, cocaine, opioids), withdrawal syndromes (opioid and alcohol), acute and chronic pain, and severe psychomotor agitation. While ketamine's role in depression and suicidality is well established, the paper focuses on these less common indications.
Asian journal of psychiatry
June 1, 2026
Fabiola Raffone, Filippo Mazzoni, Arianna De Ciechi et al.
3 citations
In a six-month observational study of 90 outpatients with treatment-resistant depression receiving intranasal esketamine, those with and without comorbid borderline personality disorder showed sustained reductions in suicidal ideation, suicidal behavior, and deliberate self-harm. Improvements were significant from month one onward. Self-harm episode frequency in the borderline group dropped from a mean of 30.8 at baseline to 2.4 at six months. Baseline impulsivity correlated with self-harm and suicidal measures, but these associations weakened by six months. No serious adverse events, treatment discontinuations, or increases in suicidality occurred. Controlled studies are needed to confirm durability, especially for patients with borderline personality disorder.
Asian journal of psychiatry
June 1, 2026
Hariprasad Ganapathy Vijayakumar, Varsha Shamanna, Harsh Pathak et al.
1 citation
In a 69-year-old man with chronic multi-therapy resistant bipolar depression, combining intravenous ketamine three times per week with sequential theta burst stimulation led to complete remission that persisted at a two-year follow-up. The patient had previously failed numerous antidepressants, mood stabilizers, electroconvulsive therapy, and standalone brain stimulation. Clinical improvement was measured by a drop in the Hamilton Depression Rating Scale from 15 to 8 and eventually to remission. Electroencephalography showed corrected dysregulated brain activity patterns, suggesting changes in short-term adaptive plasticity. This combination may offer a treatment path for patients who do not respond to standard therapies.
Asian journal of psychiatry
June 20, 2025
1 citation
Mindfulness-Based Stress Reduction (MBSR) helps students in Asian educational contexts by alleviating anxiety, enhancing emotional regulation, and fostering psychological resilience, as affirmed by a systematic review by Hue et al. However, five underexplored dimensions remain: integrating MBSR into formal curricula, understanding its neuropsychological mechanisms, addressing digital and geographic accessibility challenges in Asia, developing culturally adapted hybrid delivery models, and comparing MBSR with indigenous contemplative practices like dhikr, vipassana, zazen, and samatha. Addressing these gaps is essential for creating culturally relevant, pedagogically sound, and scalable MBSR interventions for Asian educational systems.
Asian journal of psychiatry
December 1, 2024
Jun Zhong, Fengchun Wu, Huawang Wu et al.
1 citation
Chronic ketamine users show worse cognitive performance than healthy controls in visual learning, speed of processing, working memory, and overall cognition. Brain scans reveal stronger functional connectivity between the right anterior cingulate cortex and the right postcentral gyrus in users. This enhanced connectivity is positively linked to reasoning and problem-solving scores, suggesting it may serve as a compensatory mechanism for cognitive deficits. No significant relationship was found between this connectivity and characteristics of ketamine use.
Asian journal of psychiatry
September 1, 2024
Kaori Ishii, Kyoji Okita
1 citation
In Japan, more people are misusing the over-the-counter drug dextromethorphan (DXM), often to cope with severe trauma-related and mood symptoms. These patients have substance use disorders and self-medicate with DXM. Because ketamine has similar psychopharmacological effects to DXM, the authors propose that ketamine could serve as an alternative pharmacological treatment for these patients.
Asian journal of psychiatry
June 1, 2025
Prateek Yadav, Neha Sharma, Harpreet Singh et al.
The Equanimity Scale (ES-16) was translated into Hindi and tested for reliability and validity with 83 bilingual participants. The translated version showed a Cronbach's alpha of 0.725, indicating acceptable internal consistency, and demonstrated good construct validity and cultural relevance. Factor analysis supported the scale's structure. The Hindi ES-16 provides an objective measure of equanimity, a state of psychological composure under stress, and is intended for use in mindfulness-based interventions with Hindi-speaking populations in India.
Asian journal of psychiatry
December 1, 2024
Hitesh Kumar Behera, Ramesh Joga, Sravani Yerram et al.
Psychedelic drug therapy shows promise for treating depression, PTSD, and anxiety, differing from conventional psychiatry in mechanism, legal status, and approach. This review covers the therapeutic potential, mechanisms, and regulatory approvals of psilocybin, MDMA, mescaline, ketamine, and LSD. It outlines legal aspects and regulations in the US and Europe, noting their Schedule I classification due to misuse potential. The FDA monitors psychedelics using expedited pathways and has issued guidance for clinical investigations. The EMA focuses on atypical psychedelics, addressing safety and efficacy challenges. Marketed products like Spravato nasal spray face limited distribution. Careful regulation and legislation are needed to harness therapeutic benefits.