Current Status of Ketamine and Related Compounds for Depression

Experimental Therapeutics and Pathophysiology, National Institute of Mental Health (NIMH), 베서스다, Maryland, United States
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 05/2013; 74(5):516-7. DOI: 10.4088/JCP.13ac08382
Source: PubMed
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    • "In the past decade, a large body of research has been done on the use of ketamine in depression (for reviews, see Aan het Rot et al., 2012; Mathews and Zarate, 2013). Strong but short-lasting effects have been found for treatment-resistant unipolar depression (Zarate et al., 2006) and bipolar depression (DiazGranados et al., 2010a) as well as suicidal ideation (DiazGranados et al., 2010b). "
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    ABSTRACT: Interest in the therapeutic potential of psychedelic substances has recently resumed. During an early phase of human psychedelic research, their therapeutic application in different pathologies had been suggested, and the first evidence for efficacy was provided. The range of recent clinical applications of psychedelics spans from cluster headaches and obsessive-compulsive disorder to addiction and the treatment of fear and anxiety in patients suffering from terminal illness, indicating potentially different therapeutic mechanisms. A variety of approaches in psychotherapy emphasize subjective experiences, such as so-called peak experiences or afterglow phenomena, as differentially mediating therapeutic action. This review aims to re-evaluate earlier and recent concepts of how psychedelic substances may exert beneficial effects. After a short outline of neurophenomenological aspects, we discuss different approaches to how psychedelics are used in psychotherapy. Finally, we summarize evidence for the relationship between subjective experiences and therapeutic success. While the distinction between pharmacological and psychological action obviously cannot be clear-cut, they do appear to contribute differently from each other when their effects are compared with regard to pathologies.
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    European Journal of Neuroscience 04/2014; 39(7). DOI:10.1111/ejn.12490 · 3.18 Impact Factor
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    ABSTRACT: Summary Bipolar depression remains a major challenge for psychiatric therapeutics. It is associated with disability and excess mortality, and accounts for three-quarters of the time spent in morbid states by treated patients with bipolar disorder. Major limitations of research on the treatment of depression in bipolar disorder include a paucity of short-term and lack of long-term trials, probably reflecting concern about inducing mania. In addition, polytherapy with multiple drugs appears to be widespread, but it is virtually untested for efficacy and safety. Here, we summarise the evidence concerning efficacy of treatment of bipolar depression with antidepressants, moodstabilising anticonvulsants, lithium and secondgeneration antipsychotics. Learning objectives • Gain critical appreciation of the paucity of research on the treatment of bipolar depression. • Rationally balance the benefits and risks of using antidepressants in patients with bipolar disorder. • Assess the evidence supporting a range of research-based treatment options for bipolar depression. Declaration of interest None.
    Advances in Psychiatric Treatment 04/2014; 20(20):193-201. DOI:10.1192/apt.bp.113.011460
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