Journal of child and adolescent psychopharmacology
February 1, 2023
Alice Lineham, V. Avila-Quintero, M. Bloch et al.
20 citations
Ketamine is an effective rapid-acting antidepressant, but its acute dissociative effects do not predict depression response in adolescents with treatment-resistant depression. In a secondary analysis of 16 adolescents from a crossover trial, no significant associations were found between dissociative symptoms—measured by the Clinician-Administered Dissociative States Scale—and depression improvement or response one day after ketamine infusion. When receiving the control drug midazolam, higher depersonalization symptoms were linked to less improvement. These findings contrast with some adult studies and may be limited by the small sample size, which reduces the ability to detect small or medium effects.
Journal of child and adolescent psychopharmacology
April 1, 2025
Hannah S Ishimuro, Paula K Yanes-Lukin, Pablo H Goldberg et al.
6 citations
In a small pilot trial, five adolescents with obsessive-compulsive disorder (OCD) who had not responded to first-line treatments received a single intravenous infusion of ketamine. All participants experienced mild dissociative symptoms in the 40 minutes after the infusion, but there were no abnormal vital signs, deaths, or suicidal thoughts during the two-week follow-up. Obsessive-compulsive symptom severity decreased immediately after the infusion but was not sustained over the study period. The average score on the Children's Yale-Brown Obsessive Compulsive Scale fell from 29 before treatment to 26.2 fourteen days later. The results suggest ketamine is well-tolerated in this population and warrants further testing of its efficacy.
Journal of child and adolescent psychopharmacology
May 19, 2025
Adrian Cuellar, Michael E Henry, Joshua R Smith et al.
1 citation
Electroconvulsive therapy (ECT) requires intravenous (IV) access, which can be difficult for pediatric patients and those with neurodevelopmental disorders. This case series of five patients aged 14–27 describes five strategies that helped them tolerate IV placement: oral anxiolytic premedication, planned physical restraint, intramuscular ketamine induction, inhalational sevoflurane anesthesia, and placement of an implanted venous access device. Using these individualized approaches, all patients were able to receive ECT. Consistent treatment protocols, multidisciplinary planning, and engagement of outpatient teams supported success. The findings show that adaptive strategies can improve access to ECT for special needs populations.