Medicine
September 1, 2018
61 citations
A protocol describes a planned randomized, controlled, double-blind noninferiority trial comparing a single infusion of esketamine (0.25 mg/kg) with racemic ketamine (0.5 mg/kg) for treatment-resistant depression. The primary outcome is remission rates at 24 and 72 hours after infusion. Secondary outcomes include cognition, dissociation, and blood biomarkers. The authors state that no study has directly compared these two forms, and a head-to-head test is needed to see if esketamine is comparable in efficacy and safety.
Medicine
January 31, 2018
Evangelia Liakoni, Chris Yates, Alison M. Dines et al.
38 citations
Self-reported substance use by patients arriving at emergency departments with acute recreational drug toxicity matches toxicological analysis best for heroin (86.1% agreement) and cocaine (74.1% agreement). Inhalants, poppers, and magic mushrooms were self-reported but never detected analytically. Immunoassays accurately identified methadone (100% agreement) and cocaine (95.5% agreement) but were less consistent for amphetamines (81.8% agreement). Mass spectrometry confirmed MDMA, amphetamine, methamphetamine, and new psychoactive substances in many cases where immunoassays were negative, and revealed multiple-substance use. Diagnosis of new psychoactive substance use relied primarily on self-report.
Medicine
September 15, 2023
Junye Yu, Mingyue Han, Fengru Miao et al.
26 citations
A systematic review and meta-analysis of 16 randomized controlled trials with 2,072 cancer patients found that mindfulness-based stress reduction (MBSR) programs lasting 6 to 8 weeks significantly reduced loneliness, anxiety, and depression compared to standard cancer care. The improvements were moderate in size, with the strongest effect on depression. Most studies involved breast cancer patients, and follow-up ranged from 6 to 53 weeks. The findings suggest MBSR may be a helpful mind-body approach for cancer patients experiencing these affective symptoms.
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.
Medicine
June 7, 2024
Fan Xu, Jiquan Zhang, Shaoju Xie et al.
13 citations
An 8-week Mindfulness-Based Cancer Recovery (MBCR) program added to usual care reduced anxiety, depression, post-traumatic stress disorder symptoms, and cancer-related fatigue more than usual care alone in 80 Chinese breast cancer patients undergoing chemotherapy. Both groups improved, but the MBCR group scored lower on all three outcome scales after the intervention. The findings suggest MBCR can promote physical and mental health in this population.
Medicine
July 2, 2020
Brendan Le Daré, Thomas Gicquel, Alain Baert et al.
11 citations
A 26-year-old man with no psychiatric history and no suicidal symptoms was found dead in a locked house with large neck wounds. A dropper bottle containing LSD was near the body, and toxicology confirmed acute LSD exposure: LSD at 1460 pg/mL and O-H-LSD at 182 pg/mL in blood, with LSD, nor-LSD, and O-H-LSD in urine at 3670, 201, and 4890 ng/L. This is the first reported case of fatal self-inflicted neck wounds during acute LSD intoxication in a person without prior mental illness. The case is notable given renewed interest in LSD therapy, though the literature has not shown a link between LSD exposure and suicide risk.
Medicine
May 2, 2025
Xiaobo Bi, Junchao Dai, Jin Li
8 citations
A single intravenous injection of esketamine (0.5 mg/kg) given during general anesthesia induction reduced postoperative anxiety and depression in female thyroid cancer patients. In a randomized, double-blind, placebo-controlled trial, 80 women received either esketamine or saline. Those given esketamine had significantly lower anxiety and depression scores on the second day after surgery, along with higher levels of mature brain-derived neurotrophic factor and serotonin, and lower insulin-like growth factor-1. They also required fewer vasopressors during surgery, suggesting more stable hemodynamics. The findings indicate that esketamine may help prevent postoperative mood disturbances, possibly through changes in these serum factors.
Medicine
February 28, 2025
Yannan Ouyang, Juan Li
8 citations
A systematic review and meta-analysis of five randomized controlled trials found that esketamine nasal spray, compared to a control treatment, significantly reduced depression severity measured by the MADRS scale, increased the rate of response, and improved functioning and depressive symptoms on the Sheehan Disability Scale and PHQ-9. However, it also led to more dizziness and nausea. The results suggest esketamine nasal spray is beneficial for treatment-resistant depression.
Medicine
November 1, 2024
Xiangqian Wan, Ming Li, Xiantao Li et al.
8 citations
A subclinical dose of esketamine (0.25 mg/kg) given after umbilical cord clamping during elective cesarean sections did not reduce the incidence of postpartum depression at 14 days postpartum, as measured by the Edinburgh Postnatal Depression Scale. However, it did significantly lower postoperative pain scores on the Visual Analog Scale at 4 and 24 hours after surgery. The treatment group experienced temporary increases in adverse reactions and sedation scores five minutes after administration. The findings suggest esketamine may offer short-term pain relief without preventing postpartum depression.
Medicine
May 9, 2025
Lucas Bittar de Morais, Guilherme Requião Radel-Neto, Victor Alexandre Dos Santos Valsecchi et al.
5 citations
Ketamine and etomidate are similarly effective for rapid sequence intubation in critically ill patients, with no significant difference in all-cause mortality or rates of post-intubation arterial hypotension and vasoactive drug use. However, ketamine is associated with a lower risk of adrenal insufficiency, suggesting it may be preferable for patients at high risk of adrenal suppression. These findings come from a systematic review and meta-analysis of 10 randomized clinical trials involving 2862 patients.
Medicine
March 21, 2025
Lichun Xu, Aixuan Guan, Yuxin Huang
5 citations
A systematic review and meta-analysis of 14 randomized controlled trials with 1,316 participants found that online mindfulness-based interventions improved anxiety, stress, quality of life, sleep quality, and fatigue severity in cancer patients, but did not significantly affect depression. The evidence suggests these digital programs may help reduce psychological distress and other symptoms, though more rigorous trials are needed.
Medicine
September 6, 2024
Yaqing Chen, Hangye Gu, Wenwei Li et al.
5 citations
Analysis of post-marketing safety data for esketamine nasal spray, using four statistical methods on 5,132 adverse event reports from the FDA Adverse Event Reporting System (Q1 2019 to Q2 2023), identified dissociation, sedation, and hypertension as the most frequently observed adverse drug events. New rare signals were detected, including interstitial cystitis, substance abuse, and drug diversion. These findings may help healthcare professionals assess patient symptoms and identify risks during clinical use.
Medicine
July 4, 2025
İrem Ates, Esra Laloglu, Salih Kara et al.
2 citations
After liver resection surgery, infusions of either ketamine or dexmedetomidine reduced inflammation and pain compared to a control infusion. In the control group, inflammatory markers pentraxin 3, serum amyloid A, and hepcidin continued to rise 12 hours after surgery, whereas they began declining in both drug groups. Higher inflammation levels correlated with more severe pain. No difference in liver function was seen among the groups. The two drugs were similarly effective, with neither showing clear superiority.
Medicine
May 30, 2025
Zuoju Zhang, Yanhong Dong, Yuxin Sun
2 citations
A randomized controlled trial tested mindfulness-based cognitive therapy (MBCT) in patients with acute cerebral infarction. After six weeks, the MBCT group showed greater increases in purposeful rumination and self-care ability, along with reduced anxiety and depression symptoms and enhanced post-traumatic growth, compared to standard care. No significant improvements were observed in limb motor function or muscle strength. The findings suggest MBCT can support mental health and daily functioning during recovery from acute cerebral infarction.
Medicine
May 1, 2026
Hai-Lin Hu, Qi-Zhou Huang, Ping-Xia Xie
Esketamine, the S-enantiomer of ketamine, is a rapid-acting antidepressant that works primarily by blocking N-methyl-D-aspartate receptors, quickly modulating glutamate signaling and neuroplasticity. In anesthesia, it provides effective sedation with little respiratory depression. In psychiatry, intravenous and intranasal esketamine produce rapid antidepressant effects in treatment-resistant depression, with response rates of 50% to 70% within 24 hours. However, long-term safety data are limited, and concerns about dissociative symptoms, cognitive impairment, and abuse potential persist. The FDA approved intranasal esketamine for treatment-resistant depression in 2019, while other countries have adopted varying restrictions. Its use requires careful patient selection, monitoring, and risk management.
Medicine
March 6, 2026
Hongfei Xiong, Yingxue Xu, Jiayi Liu et al.
Single-dose esketamine, given orally or intranasally, effectively reduces preoperative anxiety in children. The 95% effective dose (ED95) for oral administration is 8.2125 mg/kg (95% CI: 7.4250-8.4597 mg/kg), and for intranasal administration is 2.1770 mg/kg (95% CI: 2.0952-2.1958 mg/kg). The findings indicate both safety and efficacy for this use.