Adjunctive intranasal esketamine for major depressive disorder: A systematic review of randomized double-blind controlled-placebo studies

Zheng, Wei; Cai, Dong Bin; Xiang, Ying; Jiang, Wen; Sim, Kang; Ungvári, Gábor S.; Xiong, Hui; Huang, Xing; Ning, Yu; Xiang, Yu Tao

doi:10.1016/j.jad.2020.01.002

Cited by 81 publications

(55 citation statements)

References 41 publications

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“…symptoms in adults presenting with DSM-5-defined mixed features. 22 Furthermore, our results point toward an anti-suicide effect of ketamine in this vulnerable population experiencing AIA, which, to the best of our knowledge, is the first time this has been reported. It is axiomatic that a controlled study needs to be conducted, testing the effects of ketamine in adults with narrowly defined and specified mixed features.…”

supporting

confidence: 59%

“…The dissociative anesthetic, and N-methyl-D-aspartate antagonist, ketamine, has demonstrated rapid and robust symptom relief in adults with treatment-resistant mood disorders. 21,22 In addition, ketamine exhibits short-term efficacy on measures of suicidality (eg, suicidal ideation). 23 However, the effi- on the GAD-7 were used to assess effectiveness of IV ketamine in treating symptoms of mixed features.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…24 In fact, in our sample, the more severe mixed symptoms were also associated with the most severe AIA, consistent with other studies. 22 In addition to the high prevalence of AIA symptoms, patients themselves report that treating their AIA symptoms is a priority and a key therapeutic objective in managing MDD and BD. 25 Herein, we sought to determine the effectiveness of intravenous (IV) ketamine in adults with TRD in the context of MDD or BD, who were presenting with AIA and suicidal ideation (SI).…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder

et al. 2020

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Objective: To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD). Method: Adults (N = 201) with treatment-resistant MDD or BD received repeatdose IV ketamine treatment at a community-based clinic. Mixed features were measured using symptoms of anxiety, irritability, and agitation (AIA), as measured by the Generalized Anxiety Disorder-7 (GAD-7) scale. The Quick Inventory for Depressive Symptomatology Self-Report-16 (QIDS-SR 16) was used to measure overall treatment response, and the QIDS-SR 16 suicidal ideation (SI) item was used to measure change in SI symptoms with ketamine treatment. The anxiety, irritability, and agitation items How to cite this article: McIntyre RS, Lipsitz O, Rodrigues NB, et al. The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder. Bipolar Disord.

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supporting

confidence: 59%

Section: Backg Rou N Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder

et al. 2020

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“…More recent research has focused on the clinical development of an intranasal formulation of esketamine, a racemic isomer of ketamine which may have more potent affinity for the NMDA receptor. In some studies, esketamine has shown a sustained (beyond 1 month) pattern of response in subjects with treatment-resistant depression, and maintenance of the acute response has been achieved with repeated administration (Daly et al, 2018; Popova et al, 2019; Zheng et al, 2020a). A placebo-controlled relapse prevention trial has also demonstrated prevention of depressive relapse after acute treatment (Daly et al, 2019).…”

Section: Treatmentsmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

343

365

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Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

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“…Importantly, the Food and Drug Administration has approved esketamine (a form of ketamine) nasal spray for patients with TRD. 36 Sinyor et al…”

Section: The Main Findings Of This Single-arm Open-label Trialmentioning

confidence: 99%

Association between plasma levels of BDNF and the antisuicidal effects of repeated ketamine infusions in depression with suicidal ideation

Zheng

Zhou

Wang

et al. 2020

Therapeutic Advances in Psychopharmacology

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Background: This study is the first to examine the association between plasma levels of brain-derived neurotrophic factor (BDNF) and the antisuicidal effects of repeated ketamine infusions in depressed patients with suicidal ideation. Methods: Fifty-seven depressed patients with suicidal ideation received six ketamine infusions (0.5 mg/kg) during a 12 days period. Suicidality was measured with the Scale for Suicidal Ideations (SSI-part 1), item 10 of the Montgomery–Åsberg Depression Rating Scale (MADRS), and item 3 of the Hamilton Depression Rating Scale (HAMD) at baseline, 1 day after the first infusion (1 day), 1 day after the sixth infusion (13 days), and at 2 weeks after the last infusion (26 days). Plasma levels of BDNF were measured by enzyme-linked immunosorbent assay at baseline, 13 days, and 26 days. Results: Overall, 46 (80.7%) depressed patients with suicidal ideation had an antisuicidal response at 13 days. Despite a significant reduction in suicidal symptoms over time, no changes in plasma levels of BDNF were found after ketamine treatment when compared with baseline. Correlation analysis showed that no significant association was observed between the plasma levels of BDNF and the changes in the severity of suicidal symptoms as measured by SSI-part 1, item 10 of the MADRS, or item 3 of the HAMD at 1 day, 13 days, and 26 days (all p < 0.05). Conclusion: Our results indicated that plasma levels of BDNF may not serve as a biomarker for determining the antisuicidal effects of six ketamine infusions in depressed patients with suicidal ideation.

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Adjunctive intranasal esketamine for major depressive disorder: A systematic review of randomized double-blind controlled-placebo studies

Cited by 81 publications

References 41 publications

The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder

The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Association between plasma levels of BDNF and the antisuicidal effects of repeated ketamine infusions in depression with suicidal ideation

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