Rapid Antidepressant Effect of Ketamine in the Electroconvulsive Therapy Setting

Abdallah, Chadi G.; Fasula, Madonna; Kelmendi, Benjamin; Sanacora, Gerard; Ostroff, Robert

doi:10.1097/yct.0b013e31824f8296

Cited by 112 publications

(85 citation statements)

References 30 publications

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“…1 concomitantly to eligibility (STable2). We identified 7 RCTs, 5 of which met inclusion criteria for the present investigation (Abdallah et al, 2012;Jarventausta et al, 2013;Loo et al, 2012;Wang et al, 2012;Yoosefi et al, 2014). One RCT was excluded because it lacked a clinician administered depressive rating scale .…”

Section: Literature Searchmentioning

confidence: 99%

A systematic review and meta-analysis of randomized controlled trials of adjunctive ketamine in electroconvulsive therapy: Efficacy and tolerability

McGirr

Berlim

Bond

et al. 2015

Journal of Psychiatric Research

111

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Section: Literature Searchmentioning

confidence: 99%

A systematic review and meta-analysis of randomized controlled trials of adjunctive ketamine in electroconvulsive therapy: Efficacy and tolerability

McGirr

Berlim

Bond

et al. 2015

Journal of Psychiatric Research

111

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“…Due to the inconclusive or apparent lack of efficacy of studied maintenance/augmentation strategies, for example riluzole [Mathew et al 2010;Ibrahim et al 2012a] and electroconvulsive therapy [Abdallah et al 2012;Järventausta et al 2013], repeated-dose ketamine has now emerged as the most promising antidepressant maintenance strategy (Table 2). aan het Rot and colleagues published preliminary data exploring the safety and efficacy of repeated ketamine infusions for treatment-resistant depression (TRD) [aan het , which was followed by a larger trial inclusive of these subjects [Murrough et al 2013b].…”

Section: Multiple Infusion Studiesmentioning

confidence: 99%

Ketamine and other N-methyl-D-aspartate receptor antagonists in the treatment of depression: a perspective review

Iadarola

Niciu

Richards

et al. 2015

Therapeutic Advances in Chronic Disease

182

117

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Current pharmacotherapies for major depressive disorder (MDD) and bipolar depression (BDep) have a distinct lag of onset that can generate great distress and impairment in patients. Furthermore, as demonstrated by several real-world effectiveness trials, their efficacy is limited. All approved antidepressant medications for MDD primarily act through monoaminergic mechanisms, agonists or antagonists with varying affinities for serotonin, norepinephrine and dopamine. The glutamate system has received much attention in recent years as an avenue for developing novel therapeutics. A single subanesthetic dose infusion of the noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist ketamine has been shown to have rapid and potent antidepressant effects in treatment-resistant MDD and BDep. In a reverse translational framework, ketamine's clinical efficacy has inspired many preclinical studies to explore glutamatergic mechanisms of antidepressant action. These studies have revealed enhanced synaptic plasticity/synaptogenesis via numerous molecular and cellular mechanisms: release of local translational inhibition of brain-derived neurotrophic factor and secretion from dendritic spines, mammalian target of rapamycin activation and glycogen synthase kinase-3 inhibition. Current efforts are focused on extending ketamine's antidepressant efficacy, uncovering the neurobiological mechanisms responsible for ketamine's antidepressant activity in biologically enriched subgroups, and identifying treatment response biomarkers to personalize antidepressant selection. Other NMDA receptor antagonists have been studied both preclinically and clinically, which have revealed relatively modest antidepressant effects compared with ketamine but potentially other favorable characteristics, for example, decreased dissociative or psychotomimetic effects; therefore, there is great interest in developing novel glutamatergic antidepressants with greater target specificity and/or decreased adverse effects.

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“…Semptomlarda belirgin iyileşme görebilmek için ortalama 5-7 seans gerekmektedir (21). Yapılan farklı çalışmalarda, EKT sırasında kullanılan ketaminin, depresyon semptomları üzerinde olumlu etkisi olduğunu gösteren çalışmalar bulunmakla birlikte, aksine herhangi bir olumlu katkısı olmadığına dair sonuçların bulunduğu çalışmalar da mevcuttur (11)(12)(13)(14)(15)(16)(17)(18)(22)(23)(24)(25). Ketamin kliniğimizde EKT uygulaması sırasında nadiren uygulanan bir anestezi ajanıdır.…”

Section: Discussionunclassified

Effect of Ketamine, Thiopental and Ketamine–Thiopental Combination during Electroconvulsive Therapy for Depression

Kuşçu¹,

Karacaer²,

Biricik³

et al. 2015

Turk J Anaesth Reanim

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Objective: We aimed to evaluate the effect of anaesthesia with thiopental (4 mg kg ) and ketamine− thiopental (1 mg kg −1 and 4 mg kg −1 , respectively) combination during electroconvulsive therapy (ECT) on the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HAM-A) and haemodynamic variables in patients with resistant major depression. Methods:Patients with HDRS scores above 17 were included. The patients were randomly divided into three groups according to the anaesthesia used. Group 1 was given thiopental (4 mg kg ) was administered in all patients for muscle relaxation. HDRS and HAM-A scores were evaluated before ECT, after 3, 6. ECT and after the final ECT. Systolic and diastolic blood pressures, heart rates and oxygen saturations were recorded before and after anaesthesia induction and after the ECT procedure. Seizure duration was recorded.Results: Fifty-eight patients were included in the study. Thirty (52%) patients were male and 28 (48%) were female. The mean age was 42.7±15.8 years in Group 1, 44.8±11 years in Group 2 and 38.6±6.8 years in Group 3. In all groups, HDRS scores were reduced compared with the baseline values. There was no statistical significant difference between the groups regarding HDRS scores. HAM-A scores were higher in Group 2 and Group 3. Systolic and diastolic blood pressures and heart rate values were lower in Group 1 and the difference was statistically significant. Conclusion:In this study, anaesthesia induced with thiopental, ketamine and thiopental-ketamine combination was observed to not result in a difference in ECT for patients with treatment-resistant depression. Ketamine at a dose of 1 mg kg −1 given just before ECT did not enhance the antidepressant effect of ECT; however, anxiety scores were increased with ketamine application.Keywords: Depression, anxiety, thiopental, ketamine, electroconvulsive therapy Amaç: İlaç tedavisine dirençli major depresyon vakalarında elektrokonvülsif tedavide (EKT) anestezi indüksiyonunda tiyopental, ketamin ve ketamin-tiyopental kombinasyonunun Hamilton Depresyon Değerlendirme Ölçeği (HDDÖ), Hamilton Anksiyete Değerlendirme Ölçeği (HADÖ) ve hemodinami üzerine etkilerini değerlendirmeyi amaçladık.

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Rapid Antidepressant Effect of Ketamine in the Electroconvulsive Therapy Setting

Cited by 112 publications

References 30 publications

A systematic review and meta-analysis of randomized controlled trials of adjunctive ketamine in electroconvulsive therapy: Efficacy and tolerability

A systematic review and meta-analysis of randomized controlled trials of adjunctive ketamine in electroconvulsive therapy: Efficacy and tolerability

Ketamine and other N-methyl-D-aspartate receptor antagonists in the treatment of depression: a perspective review

Effect of Ketamine, Thiopental and Ketamine–Thiopental Combination during Electroconvulsive Therapy for Depression

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