The World Journal of Biological Psychiatry
November 3, 2020
Siegfried Kasper, Wiesław Jerzy Cubała, Andrea Fagiolini et al.
84 citations
Esketamine nasal spray, an NMDA glutamate receptor antagonist, offers a fast-acting treatment option for patients with treatment-resistant depression (TRD) who have not responded to several prior therapies. A group of six European experts with clinical experience using esketamine nasal spray developed consensus statements on practical considerations before, during, and after administration. The guidance is based on their experience and available literature, aiming to help clinicians unfamiliar with the treatment. Further real-world use is expected to expand existing knowledge.
The World Journal of Biological Psychiatry
May 12, 2008
Michael Liebrenz, Rudolf Stohler, Alain Borgeat
73 citations
In a 55-year-old man with treatment-resistant major depression and co-occurring alcohol and benzodiazepine dependence, a single intravenous infusion of ketamine (0.5 mg/kg) produced a pronounced improvement in depression symptoms, peaking two days later (Hamilton Depression Rating Scale down 56.6%, Beck Depression Inventory down 65.4%). Positive effects began fading by day 7 and returned to baseline by day 35. A second infusion six weeks later was less effective, reducing symptoms by 43% and 35% respectively, with effects lasting only 7 days. Repeated ketamine administration can be beneficial, but the diminished response to the second dose suggests that optimal dosing and scheduling require further investigation.
The World Journal of Biological Psychiatry
March 1, 2010
Patrik Roser, Franz X. Vollenweider, Wolfram Kawohl
63 citations
Delta(9)-Tetrahydrocannabinol (THC), the main psychoactive component of cannabis, can cause psychomotor effects, psychotic reactions, and cognitive impairment similar to schizophrenia. These effects can be reduced by two other cannabinoids: cannabidiol (CBD) and SR141716. CBD, the second most abundant cannabis constituent, weakly antagonizes the CB(1) receptor, inhibits anandamide reuptake and hydrolysis, and has neuroprotective antioxidant activity. SR141716 is a potent and selective CB(1) receptor antagonist. Both can reverse many effects of CB(1) receptor agonists, suggesting antipsychotic properties. Experimental studies in animals, healthy volunteers, and schizophrenic patients support this, with a pharmacological profile similar to atypical antipsychotic drugs. This review presents preclinical and clinical studies on the potential antipsychotic effects of CBD and SR141716.
The World Journal of Biological Psychiatry
January 1, 2004
Roman J Nielen, Frank Mma van der Heijden, S. Tuinier et al.
42 citations
Two cases of khat-induced psychosis and two of psilocybin-induced psychosis are described. Khat-induced psychotic symptoms resolved without treatment within one week. One psilocybin-induced psychosis patient was treated with risperidone; the other's symptoms subsided in a few days. No somatic medical complications occurred. The paper stresses adequate psychiatric diagnosis and treatment, negative social consequences of drug use, and the need to distinguish these from functional psychoses, especially in patients with psychiatric comorbidity.
The World Journal of Biological Psychiatry
January 11, 2016
Matthew Cooper, Joshua D. Rosenblat, Danielle S. Cha et al.
40 citations
Ketamine produces rapid antidepressant effects but can cause psychotomimetic and dissociative side effects, raising safety concerns. This narrative review synthesizes strategies to reduce those effects, including altering dose and infusion rate, changing the route of administration, choosing a specific enantiomer, co-administering mood stabilizers or antipsychotics, and using alternative NMDA-modulating agents like lanicemine and GLYX-13. Intranasal administration appears the most promising approach for mitigating dissociative and psychotomimetic effects, but the available studies are limited in number and quality, so further investigation is needed.
The World Journal of Biological Psychiatry
January 5, 2022
Matti Gärtner, Mischa de Rover, Lena Václavů et al.
11 citations
In patients with Major Depressive Disorder, increased blood flow in the thalamus one day after a single low-dose ketamine infusion is linked to greater improvement in depressive symptoms. Lower thalamus blood flow before treatment predicts both a larger increase in flow after ketamine and stronger symptom reduction. The study used arterial spin labelling, a brain imaging technique that directly measures cerebral blood flow, avoiding the ambiguity of standard BOLD imaging. These findings suggest that measuring regional blood flow could help guide ketamine treatment decisions.
The World Journal of Biological Psychiatry
June 20, 2023
Maria Gałuszko‐węgielnik, Katarzyna Jakuszkowiak‐wojten, Alina Wilkowska et al.
9 citations
A woman with both bipolar disorder and borderline personality disorder received intravenous ketamine for acute depression. While ketamine initially improved her depressed mood, continued treatment led to increased nonsuicidal self-injury, impulsive behavior, and worsening dissociative symptoms. Treatment was stopped and replaced with a different medication that proved helpful. The authors conclude that ketamine's effects on emotional dysregulation and impulsivity are unclear and differ from its antidepressant effects, highlighting the need for more safety and effectiveness studies in this patient group.