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Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: a double-blind, randomized, placebo-controlled multi-center clinical trial.

Abdallah, C.G., Roache, J.D., Gueorguieva, R. et al. Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: a double-blind, randomized, placebo-controlled multi-center clinical trial. Neuropsychopharmacol. 47, 1574–1581 (2022). Highlights: The standard ketamine dose treated depression significantly more than placebo. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 h and were less pronounced with repeated administration. Involved 158 veterans and service members with treatment resistant PTSD that failed prior antidepressant treatments in the past. Veterans were divided into a placebo group, and 2 separate ketamine treatment groups; a low dose group (0.2mg/kg), and a standard dose group (0.5mg/kg). Results and Conclusions: The primary outcome measure was the self-report PTSD Checklist forDSM-5 (PCL-5), and secondary outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Montgomery Åsberg Depression Rating Scale (MADRS). The standard ketamine dose ameliorated depression measured by the MADRS significantly more than placebo. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 h and were less pronounced with repeated administration. There was no evidence of differential treatment discontinuation by ketamine dose, consistent with good tolerability. This clinical trial failed to find a significant dose-related effect of ketamine on PTSD symptoms. Secondary analyses suggested that the standard dose exerted rapid antidepressant effects.

bipolar

Ketamine for Treatment-Resistant Mood Disorders.

Park LT, Falodun TB, Zarate CA Jr. Ketamine for Treatment-Resistant Mood Disorders. Focus (Am Psychiatr Publ). 2019 Jan;17(1):8-12. doi: 10.1176/appi.focus.20180030. Epub 2019 Jan 7. PMID: 31975953; PMCID: PMC6493154.   Highlights: Strong evidence supports the rapid, although temporary, antidepressant effects of a single intravenous ketamine infusion for treatment-resistant major depressive disorder (MDD) and bipolar depression. Intravenous ketamine administration for treatment-resistant depression (TRD) is generally safe and well tolerated when administered by trained professionals. Ketamine research is transforming our understanding of the pathophysiology of mood disorders and leading the way toward developing new, rapid-acting interventions for TRD.   Conclusions: Strong evidence supports the rapid, although temporary, antidepressant and antisuicidal effects of a single intravenous ketamine infusion for treatment-resistant MDD and bipolar depression. Continued investigation of ketamine via various routes of administration will continue to provide information about long-term safety and effectiveness for the treatment of depression. Given the growing use of intravenous ketamine and the potential approval of intranasal esketamine in the near future, evidence-based treatment recommendations for the use of ketamine in mood disorders need to be established.

Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: a double-blind, randomized, placebo-controlled multi-center clinical trial.

Abdallah, C.G., Roache, J.D., Gueorguieva, R. et al. Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: a double-blind, randomized, placebo-controlled multi-center clinical trial. Neuropsychopharmacol. 47, 1574–1581 (2022). Highlights: The standard ketamine dose treated depression significantly more than placebo. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 h and were less pronounced with repeated administration. Involved 158 veterans and service members with treatment resistant PTSD that failed prior antidepressant treatments in the past. Veterans were divided into a placebo group, and 2 separate ketamine treatment groups; a low dose group (0.2mg/kg), and a standard dose group (0.5mg/kg). Results

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bipolar

Ketamine for Treatment-Resistant Mood Disorders.

Park LT, Falodun TB, Zarate CA Jr. Ketamine for Treatment-Resistant Mood Disorders. Focus (Am Psychiatr Publ). 2019 Jan;17(1):8-12. doi: 10.1176/appi.focus.20180030. Epub 2019 Jan 7. PMID: 31975953; PMCID: PMC6493154.   Highlights: Strong evidence supports the rapid, although temporary, antidepressant effects of a single intravenous ketamine infusion for treatment-resistant major depressive disorder (MDD) and bipolar depression. Intravenous ketamine administration for treatment-resistant depression (TRD) is generally safe and well tolerated when administered by trained professionals. Ketamine research is transforming our understanding of the pathophysiology of mood disorders and leading the way toward developing new, rapid-acting interventions for TRD.   Conclusions: Strong evidence supports the rapid, although temporary, antidepressant and antisuicidal effects of a

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how ketamine works

(R)-Ketamine Rapidly Ameliorates the Decreased Spine Density in the Medial Prefrontal Cortex and Hippocampus of Susceptible Mice After Chronic Social Defeat Stress. Ketamine demonstrates neuroplasticity. Neuroplasticity is hypothesized to be a key component to mental health recovery.

Zhang J, Qu Y, Chang L, Pu Y, Hashimoto K. (R)-Ketamine Rapidly Ameliorates the Decreased Spine Density in the Medial Prefrontal Cortex and Hippocampus of Susceptible Mice After Chronic Social

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ketamine vs antidepressant
IV ketamine

Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active-duty military: a double-blind, randomized, placebo-controlled multi-center clinical trial.

Highlights: The standard ketamine dose-treated depression significantly more than placebo. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 h and were less pronounced with repeated administration.

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ketamine Nasal spray bottle
bipolar

Ketamine for Treatment-Resistant Mood Disorders

Highlights: Strong evidence supports the rapid, although temporary, antidepressant effects of a single intravenous ketamine infusion for treatment-resistant major depressive disorder (MDD) and bipolar depression. Intravenous ketamine administration for treatment-resistant

Read More »
IV ketamine

Ketamine Infusion for Obsessive-Compulsive Disorder.

Bloch MH.  Ketamine Infusion for Obsessive-Compulsive Disorder. ClinicalTrials.gov.  2014 June; https://clinicaltrials.gov/study/NCT01349231 Highlights: In a placebo-controlled study completed at Yale, a single dose of ketamine (0.5 mg/kg, intravenously) had rapid antidepressant

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