Anorexia nervosa, zinc deficiency and the glutamate system: The ketamine option

Hermens, Daniel F.; Simcock, Gabrielle; Dutton, Megan; Bouças, Ana Paula; Can, Adem; Lilley, Chris; Lagopoulos, Jim

doi:10.1016/j.pnpbp.2020.109921

Cited by 20 publications

(11 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At present, the data regarding the use of ketamine and esketamine in subjects diagnosed with an ED are preliminary, limited and related to AN only. Moreover, despite positive results in animal models of AN [87][88][89] in terms of food intake, weight gain and reduced hyperactivity, evidence is lacking regarding the effects of ketamine in AN patients. Nevertheless, more compelling and substantial evidence is needed from large cohort studies.…”

Section: Ketamine In Edmentioning

confidence: 99%

Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature

et al. 2021

View full text Add to dashboard Cite

The obsessive–compulsive spectrum refers to disorders drawn from several diagnostic categories that share core features related to obsessive–compulsive disorder (OCD), such as obsessive thoughts, compulsive behaviors and anxiety. Disorders that include these features can be grouped according to the focus of the symptoms, e.g., bodily preoccupation (i.e., eating disorders, ED) or impulse control (i.e., substance use disorders, SUD), and they exhibit intriguing similarities in phenomenology, etiology, pathophysiology, patient characteristics and clinical outcomes. The non-competitive N-methyl-D-aspartate receptor (NMDAr) antagonist ketamine has been indicated to produce remarkable results in patients with treatment-resistant depression, post-traumatic stress disorder and OCD in dozens of small studies accrued over the past decade, and it appears to be promising in the treatment of SUD and ED. However, despite many small studies, solid evidence for the benefits of its use in the treatment of OCD spectrum and addiction is still lacking. Thus, the aim of this perspective article is to examine the potential for ketamine and esketamine in treating OCD, ED and SUD, which all involve recurring and intrusive thoughts and generate associated compulsive behavior. A comprehensive and updated overview of the literature regarding the pharmacological mechanisms of action of both ketamine and esketamine, as well as their therapeutic advantages over current treatments, are provided in this paper. An electronic search was performed, including all papers published up to April 2021, using the following keywords (“ketamine” or “esketamine”) AND (“obsessive” OR “compulsive” OR “OCD” OR “SUD” OR “substance use disorder” OR “addiction” OR “craving” OR “eating” OR “anorexia”) NOT review NOT animal NOT “in vitro”, on the PubMed, Cochrane Library and Web of Science online databases. The review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The use and efficacy of ketamine in SUD, ED and OCD is supported by glutamatergic neurotransmission dysregulation, which plays an important role in these conditions. Ketamine’s use is increasing, and preliminary data are optimistic. Further studies are needed in order to better clarify the many unknowns related to the use of both ketamine and esketamine in SUD, ED and OCD, and to understand their long-term effectiveness.

show abstract

Section: Ketamine In Edmentioning

confidence: 99%

Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In light of recent interest in the use of psychedelicassisted psychotherapy for eating disorders and the limited treatment options for eating disorders, further examination of the therapeutic potential of ketamine for eating disorders is warranted. [115][116][117][118] With regard to personality disorders, the high levels suicidality associated with borderline personality makes research on ketamine for suicidality also a priority among this population. Moreover, in light of the positive effects of ketamine for depressive disorders, the lack of research on the use of ketamine in the treatment of postpartum depression is a notable gap that demands consideration.…”

Section: Discussionmentioning

confidence: 99%

Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review

et al. 2021

View full text Add to dashboard Cite

Background In the past two decades, subanaesthetic doses of ketamine have been demonstrated to have rapid and sustained antidepressant effects, and accumulating research has demonstrated ketamine's therapeutic effects for a range of psychiatric conditions. Aims In light of these findings surrounding ketamine's psychotherapeutic potential, we systematically review the extant evidence on ketamine's effects in treating mental health disorders. Method The systematic review protocol was registered in PROSPERO (identifier CRD42019130636). Human studies investigating the therapeutic effects of ketamine in the treatment of mental health disorders were included. Because of the extensive research in depression, bipolar disorder and suicidal ideation, only systematic reviews and meta-analyses were included. We searched Medline and PsycINFO on 21 October 2020. Risk-of-bias analysis was assessed with the Cochrane Risk of Bias tools and A Measurement Tool to Assess Systematic Reviews (AMSTAR) Checklist. Results We included 83 published reports in the final review: 33 systematic reviews, 29 randomised controlled trials, two randomised trials without placebo, three non-randomised trials with controls, six open-label trials and ten retrospective reviews. The results were presented via narrative synthesis. Conclusions Systematic reviews and meta-analyses provide support for robust, rapid and transient antidepressant and anti-suicidal effects of ketamine. Evidence for other indications is less robust, but suggests similarly positive and short-lived effects. The conclusions should be interpreted with caution because of the high risk of bias of included studies. Optimal dosing, modes of administration and the most effective forms of adjunctive psychotherapeutic support should be examined further.

show abstract

“…This underlying neuroendocrinological dysregulation is not only associated with core facets of ASC etiology, but also has direct functional implications for stress-related psychopathology. A disruption of glutamatergic and GABAergic signaling contributes to the etiology of anxiety disorders (313)(314)(315)(316), PTSD (317), eating disorders (318)(319)(320), OCD (321) and substance use disorders (SUDs) (322,323). The serotonergic, dopaminergic and noradrenergic systems are implicated in MDD, anxiety and SUDs (324)(325)(326) while serotonin is also associated with mood disorders, stress, aggression and anti-social conduct (327)(328)(329), and dopamine is thought to play a role in eating disorders (330,331), executive dysfunction and behavioral inhibition (332,333).…”

Section: From Mal To Neurophysiology Neurochemistry and Behavior: A M...mentioning

confidence: 99%

A Molecular Framework for Autistic Experiences: Mitochondrial Allostatic Load as A Mediator between Autism and Psychopathology

Mahony¹,

O’Ryan²

2022

Preprint

View full text Add to dashboard Cite

Molecular autism research is evolving towards a biopsychosocial framework that is more informed by autistic experiences. In this context, research aims are moving away from correcting external autistic behaviors and towards alleviating internal distress. Autism Spectrum Conditions (ASCs) are associated with high rates of depression, suicidality and other comorbid psychopathologies, but this relationship is poorly understood. Here, we integrate emerging characterizations of internal autistic experiences within a molecular framework to yield insight into the prevalence of psychopathology in ASC. We demonstrate that descriptions of social camouflaging and autistic burnout resonate closely with the accepted definitions for early life stress (ELS) and chronic adolescent stress (CAS). We propose that social camouflaging could be considered a distinct form of CAS that contributes to allostatic overload, culminating in a pathophysiological state that is experienced as autistic burnout. Autistic burnout is thought to contribute to psychopathology via psychological and physiological mechanisms, but these remain largely unexplored by molecular researchers. Building on converging fields in molecular neuroscience, we discuss the substantial evidence implicating mitochondrial dysfunction in ASC to propose a novel role for mitochondrial allostatic load in the relationship between autism and psychopathology. An interplay between mitochondrial, neuroimmune and neuroendocrine signaling is increasingly implicated in stress-related psychopathologies, and these molecular players are also associated with neurodevelopmental, neurophysiological and neurochemical aspects of ASC etiology. Together, this suggests an increased exposure and underlying molecular susceptibility to ELS that increases the risk of psychopathology in ASC. This article describes an integrative framework shaped by autistic experiences that highlights novel avenues for molecular research into mechanisms that directly affect the quality of life and well-being of autistic individuals. Moreover, this framework emphasizes the need for increased access to diagnoses, accommodations, and resources to improve mental health outcomes in autism.

show abstract

Anorexia nervosa, zinc deficiency and the glutamate system: The ketamine option

Cited by 20 publications

References 75 publications

Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature

Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature

Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review

A Molecular Framework for Autistic Experiences: Mitochondrial Allostatic Load as A Mediator between Autism and Psychopathology

Contact Info

Product

Resources

About