Related Experiment Video
Updated: Dec 30, 2025
04:29
Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
29.4K
Ketamine for Treatment-Resistant Mood Disorders
Lawrence T Park1, Tolulope B Falodun1, Carlos A Zarate1
1Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD (Park, Falodun, Zarate).
Focus (American Psychiatric Publishing)
|January 25, 2020
Summary
Intravenous ketamine infusions offer rapid, temporary relief for treatment-resistant depression. Further research is needed to understand long-term effects and establish treatment guidelines for this emerging therapy.
Area of Science:
- Neuroscience and Psychiatry
- Pharmacology of Antidepressants
Background:
- Major depressive disorder (MDD) and bipolar depression treatments often face challenges with resistance.
- Ketamine shows rapid, albeit temporary, antidepressant effects, particularly via intravenous infusion.
- Current hypotheses link ketamine's efficacy to N-methyl-D-aspartate (NMDA) receptor antagonism.
Purpose of the Study:
- To review the current understanding of ketamine's antidepressant effects, administration, and safety.
- To highlight the need for further research into long-term safety and efficacy of repeated ketamine use.
- To emphasize the necessity of developing standardized treatment guidelines for ketamine in psychiatric disorders.
Main Methods:
- Review of existing evidence on intravenous ketamine for treatment-resistant depression (TRD).
- Discussion of emerging data on intranasal esketamine trials.
- Analysis of known and potential side effects, including dissociative effects and abuse potential.
Main Results:
- Single intravenous ketamine infusions are generally safe and effective for short-term antidepressant effects in TRD.
- The long-term safety and effectiveness of repeated ketamine infusions are not well-established.
- Intranasal esketamine is progressing towards regulatory approval for TRD.
Conclusions:
- Ketamine represents a significant advancement in rapid-acting antidepressant therapies.
- Further research is crucial to address knowledge gaps regarding long-term ketamine use.
- Standardized guidelines are essential for the safe and effective clinical application of ketamine.
Related Concept Videos
01:30Electroconvulsive Therapy
688
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
688
01:26Psychosis: Goals of Pharmacotherapy
404
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
404
01:24Parenteral Anesthetics: Overview
516
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
516
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
447
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
447
01:24Mania and Antimanic Drugs: Overview
495
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
495
01:23Antidepressant Drugs: MAOIs and Other Agents
718
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
718