The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
January 1, 2025
Christine Reif-Leonhard, Shannon N Millard, Dorsa Ferdowssian et al.
3 citations
Repeated intravenous esketamine infusions improved emotion recognition for all emotions except sadness, where accuracy decreased, particularly for low-intensity expressions. Misclassifications of other emotions as sad also decreased, indicating a reduced response bias towards sadness. This shift emerged after the first infusion and consolidated over time. Participants showed significant reductions in feelings of sadness and irritability, and cognitive functioning improved. Among those receiving at least five infusions, 66.7% showed significant improvement. The findings suggest that esketamine's antidepressant effects may involve changes in emotion processing and cognition, with acute mood-lifting effects distinguishable from longer-lasting responses that consolidate after repeated administration.
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
June 1, 2026
Chittaranjan Behera, Srishti Gupta, Richard Shelton et al.
2 citations
Inflammation and immune dysregulation are linked to suicidal behavior. People with suicidal behavior show elevated levels of pro-inflammatory cytokines (interleukin-6, interleukin-1β, tumor necrosis factor-α), C-reactive protein, and chemokines in blood, cerebrospinal fluid, and brain tissue. These markers disrupt the hypothalamic-pituitary-adrenal axis, monoamine systems, and glutamatergic signaling. Inflammatory activation of indoleamine 2,3-dioxygenase shifts tryptophan metabolism toward neurotoxic kynurenine metabolites, reducing serotonin and promoting excitotoxicity, potentially increasing impulsivity and acute suicidal ideation. Several immunomodulatory treatments—including lithium, ketamine, COX-2 inhibitors, cytokine antagonists, and kynurenine-pathway modulators—show promise in reducing inflammation-linked suicidal risk. Precision-based approaches integrating biomarkers, genetics, and clinical profiles may help identify individuals likely to benefit from these therapies.
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
November 1, 2024
S Graf, G Dörl, C Milz et al.
2 citations
Ketamine's rapid antidepressant effects are linked to enhanced neuroplasticity in the amygdala and hippocampus, brain regions involved in fear and learning. Anxiety during ketamine infusion is associated with poorer treatment outcomes. In a single-blind, placebo-controlled study, 17 healthy volunteers received placebo then 0.5 mg/kg ketamine intravenously. Anxiety was measured using the 5D-ASC score, and brain scans were taken 4 hours after infusion. Smaller hippocampal head volume significantly predicted greater anxiety (β = -0.733, p = 0.006), with similar trends for subfields. Hippocampal subfield volumes may help predict anxiety-related experiences during ketamine use and potentially treatment outcomes.
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
January 22, 2026
David Eckert, Siegfried Kasper
For treatment-resistant depression, lithium, quetiapine, and esketamine are all effective augmentation options. A systematic review of head-to-head studies found only four trials: three comparing lithium and quetiapine, and one comparing esketamine and quetiapine. The evidence suggests a descriptive superiority of esketamine over quetiapine and of quetiapine over lithium. However, because the three drugs have fundamentally different properties, side effects, and contraindications, the choice should be made in a comprehensive clinical context. The findings argue for re-evaluating existing treatment algorithms in guidelines.