Ketamine-Induced Manic Episode

Bhatt, Kush; Yoo, Jennie; Bridges, Amber

doi:10.4088/pcc.20l02811

Cited by 10 publications

(6 citation statements)

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“…For example, macro-imaging studies have documented correlations of depressive symptom severity with brain functional and structural alterations (Vai et al, 2019 ; Gong et al, 2020 , 2021 ; Angelescu et al, 2021 ; Cahn et al, 2021 ; Keramatian et al, 2021 ). EEG studies have revealed correlations between brain neuron impairment and the severity of depressive symptoms (Banwari et al, 2015 ; Zhou et al, 2015 ; Liu et al, 2018 ; Belleau et al, 2019 ; Bhatt et al, 2021 ; Gao et al, 2021 ). We found no correlation between brain neuron impairment and the severity of manic-like symptoms, inconsistent with many previous findings (Dixon et al, 1994 ; Brody et al, 2003 ; Ettenberg et al, 2020 ; Gao et al, 2021 ), which may be related to the “double-hit” nature of our murine model.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical and macro-neuroimaging findings suggest that cognitive impairment is a core symptom in patients with BP; micro-neuroimaging studies have also revealed cognitive impairment in animal models of mania and depression (Banwari et al, 2015 ; Zhou et al, 2015 ; Hiser and Koenigs, 2018 ; Belleau et al, 2019 ; Mondimore, 2020 ; Harrison et al, 2021 ; Bhatt et al, 2021 ; Gao et al, 2021 ). Our data constitute new evidence for this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…First, we established the depressive phase by exposing the mice to CUMS using a standard protocol to provoke depressive behavior. One day later, according to a BP model designed to mimic a protocol for mania prevention (Banwari et al, 2015 ; Bhatt et al, 2021 ; Gao et al, 2021 ), we initiated a course of daily intraperitoneal injection of ketamine (25 mg/kg) to provoke manic behavior (Liu et al, 2018 ; Bhatt et al, 2021 ; Gao et al, 2021 ). Assessments were performed after the establishment of each phase.…”

Section: Methodsmentioning

confidence: 99%

“…The exploration of brain activity alterations in the same animal model during first the depressive phase and then the manic phase can provide evidence aiding the understanding of the pathological features of BP. Such models are particularly suitable for the examination of brain activity features in the antidepressant-induced manic phase of BP, as they often involve the use of ketamine to induce mania (Liu et al, 2018 ; Bhatt et al, 2021 ; Gao et al, 2021 ). Ketamine has an antidepressant effect and can rapidly alleviate serious depressive symptoms (Meshkat et al, 2021 ; Muscat et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes

Chen

Tian

et al. 2022

Front. Behav. Neurosci.

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Background: In the treatment of patients with bipolar disorder (BP), antidepressant-induced mania is usually observed. The rate of phase switching (from depressive to manic) in these patients exceeds 22%. The exploration of brain activity patterns during an antidepressant-induced manic phase may aid the development of strategies to reduce the phase-switching rate. The use of a murine model to explore brain activity patterns in depressive and manic phases can help us to understandthe pathological features of BP. The novel object recognition preference ratio is used to assess cognitive ability in such models.Objective: To investigate brain Ca2+ activity and behavioral expression in the depressive and manic phases in the same murine model, to aid understanding of brain activity patterns in phase switching in BP.Methods: In vivo two-photon imaging was used to observe brain activity alterations in a murine model in which induce depressive-like and manic-like behaviors were induced sequentially. The immobility time was used to assess depressive-like symptoms and the total distance traveled was used to assess manic-like symptoms.Results: In vivo two-photon imaging revealed significantly reduced brain Ca2+ activity in temporal cortex pyramidal neurons in the depressive phase in mice exposed to chronic unpredictable mild stress compared with naïve controls. The brain Ca2+ activity correlated negatively with the novel object recognition preference ratio within the immobility time. Significantly increased brain Ca2+ activity was observed in the ketamine-induced manic phase. However, this activity did not correlate with the total distance traveled. The novel object recognition preference ratio correlated negatively with the total distance traveled in the manic phase.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes

Chen

Tian

et al. 2022

Front. Behav. Neurosci.

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“…Hence, in the present pilot study, we used in vivo two-photon imaging to observe brain activity alterations during the depressive and manic/hypomanic phases in a murine model of BPD. As clinical studies have shown that depressive episodes usually precede manic episodes in patients with BPD, we established the model with induction of the depressive phase by chronic unpredictable mild stress (CUMS) application [ 57 ], followed by manic-phase induction by ketamine injection [ 58 – 60 ]. We hypothesized that: (1) in vivo calcium imaging would demonstrate impaired neural activity in the temporal cortex (TPC) and prefrontal cortex (PFC), (2) this impairment would have phase-specific patterns, (3) these patterns would be associated with differences in cognitive and behavioral performance between BPD phases, and (4) the patterns would be related to macro- and micro-brain connectivity features.…”

Section: Introductionmentioning

confidence: 99%

Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study

et al. 2021

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Brain pathological features during manic/hypomanic and depressive episodes in the same patients with bipolar disorder (BPD) have not been described precisely. The study aimed to investigate depressive and manic-phase-specific brain neural activity patterns of BPD in the same murine model to provide information guiding investigation of the mechanism of phase switching and tailored prevention and treatment for patients with BPD. In vivo two-photon imaging was used to observe brain activity alterations in the depressive and manic phases in the same murine model of BPD. Two-photon imaging showed significantly reduced Ca2+ activity in temporal cortex pyramidal neurons in the depression phase in mice exposed to chronic unpredictable mild stress (CUMS), but not in the manic phase in mice exposed to CUMS and ketamine. Total integrated calcium values correlated significantly with immobility times. Brain Ca2+ hypoactivity was observed in the depression and manic phases in the same mice exposed to CUMS and ketamine relative to naïve controls. The novel object recognition preference ratio correlated negatively with the immobility time in the depression phase and the total distance traveled in the manic phase. With recognition of its limitations, this study revealed brain neural activity impairment indicating that intrinsic emotional network disturbance is a mechanism of BPD and that brain neural activity is associated with cognitive impairment in the depressive and manic phases of this disorder. These findings are consistent with those from macro-imaging studies of patients with BPD. The observed correlation of brain neural activity with the severity of depressive, but not manic, symptoms need to be investigated further.

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Ketamine

2021

Reactions Weekly

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Manic episode: case reportA 23-year-old man developed manic episode following treatment with ketamine for post-traumatic stress disorder (PTSD) and bipolar depression.The man, who had a history of polysubstance abuse, bipolar-I disorder and PTSD, was admitted to the psychiatric hospital for a manic episode with psychotic features. Approximately 5 weeks prior to his admission, ketamine treatment was recommended to treat his bipolar depression and PTSD. Therefore, he was scheduled to receive six ketamine 0.5 mg/kg infusions over 14 days. After his first ketamine infusion, he reported that his depressive symptoms, specifically agitation and hopelessness immediately improved. However, his mood became increasingly elevated with subsequent ketamine infusions. By the final ketamine infusion, he felt that he had reached a euphoric state. He developed reckless behaviour and grandiose delusions, which lead to an inpatient psychiatric hospitalisation for 5 days. He was recommended to take olanzapine after discharge; however, he never took the olanzapine medication. Over the next 3 weeks, he continued to decompensate with escalating recklessness and impulsive behaviour. He was again admitted to the hospital with a diagnosis of bipolar mania with psychotic features. Based on the clinical presentation and laboratory findings, manic episode secondary to the ketamine therapy was considered.The man was treated with lithium and aripiprazole. As a result, his condition stabilised. After 3 weeks, he achieved complete remission. Additionally, no recurrence of depressive symptoms were noted.

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Ketamine-Induced Manic Episode

Cited by 10 publications

References 0 publications

Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes

Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes

Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study

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