Basic aspects of ketamine therapy for treatment-resistant depression - a review paper
DOI:
https://doi.org/10.12775/QS.2024.19.53331Keywords
ketamine, depression, treatment-resistant, antidepressant, neuronal plasticityAbstract
Introduction and purpose: Major depressive disorder (MDD) is the most common psychiatric illness, affecting millions of people worldwide. The first line of pharmacological treatment is usually monoamine reuptake inhibitors. Up to 60% of cases, may be drug-resistant patients, prompting researchers to research substances other than conventional. 1 The purpose of this article was to review recent studies on the use of ketamine in the treatment of drug-resistant depression and present their findings.
Brief description of the state of knowledge: Ketamine has been a well-known drug used in anesthesiology and pain management for decades. Because of its multidirectional effects, researchers have become interested in its effects on psychiatric illnesses. Over the past decade or so, there has been a definite increase in research and articles on the use of ketamine in psychiatry. The study has resulted in FDA approval of esketamine for the treatment of treatment-resistant depression in adults in 2019.
Material and method: This article is the result of searching keywords on databases such as Google Scholar and Pubmed and collecting scientific literature about depression and ketamine. Articles were preselected by title, number of citations, source, and publication date.
Summary: Ketamine has the potential to be a treatment for drug-resistant depression. Its effectiveness varies with the form and dosage, with racemic and higher doses offering greater therapeutic benefits. Ketamine's efficacy is on par with the electroconvulsive therapy. Its onset is faster than traditional antidepressants, significantly reducing suicide risk in a shorter time frame. While the precise mechanisms of its antidepressant effects are not fully understood, it is suggested that its impact on brain neuroplasticity may contribute to the rapid onset of action. Growing evidence supports ketamine's effectiveness in treating TRD, highlighting the need for further research in this area.
References
DeWilde KE, Levitch CF, Murrough JW, Mathew SJ, Iosifescu DV. The promise of ketamine for treatment‐resistant depression: current evidence and future directions. Ann N Y Acad Sci. 2015;1345(1):47-58. doi:10.1111/nyas.12646
Mansuri Z, Shah B, Yadav G, et al. Is Intravenous Ketamine Better Than Intranasal Esketamine for Treating Treatment-Resistant Depression? Prim Care Companion CNS Disord. 2024;26(1). doi:10.4088/PCC.23lr03607
Crisanti C, Enrico P, Fiorentini A, Delvecchio G, Brambilla P. Neurocognitive impact of ketamine treatment in major depressive disorder: A review on human and animal studies. J Affect Disord. 2020;276:1109-1118. doi:10.1016/j.jad.2020.07.119
Edinoff AN, Akuly HA, Hanna TA, et al. Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038
Dai D, Miller C, Valdivia V, et al. Neurocognitive effects of repeated ketamine infusion treatments in patients with treatment resistant depression: a retrospective chart review. BMC Psychiatry. 2022;22(1):140. doi:10.1186/s12888-022-03789-3
Belzung C, Willner P, Philippot P. Depression: from psychopathology to pathophysiology. Curr Opin Neurobiol. 2015;30:24-30. doi:10.1016/j.conb.2014.08.013
Sobin C. Psychomotor Symptoms of Depression. M J Psychiatry. Published online 1997.
Hofmann SG, Curtiss J, Carpenter JK, Kind S. Effect of treatments for depression on quality of life: a meta-analysis. Cogn Behav Ther. 2017;46(4):265-286. doi:10.1080/16506073.2017.1304445
Villarroel MA. Symptoms of Depression Among Adults: United States, 2019. 2020;(379).
Liu B, Liu J, Wang M, Zhang Y, Li L. From Serotonin to Neuroplasticity: Evolvement of Theories for Major Depressive Disorder. Front Cell Neurosci. 2017;11:305. doi:10.3389/fncel.2017.00305
Krystal JH, Kaye AP, Jefferson S, et al. Ketamine and the neurobiology of depression: Toward next-generation rapid-acting antidepressant treatments. Proc Natl Acad Sci. 2023;120(49):e2305772120. doi:10.1073/pnas.2305772120
Matveychuk D, Thomas RK, Swainson J, et al. Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers. Ther Adv Psychopharmacol. 2020;10:204512532091665. doi:10.1177/2045125320916657
Phillips JL, Norris S, Talbot J, et al. Single and repeated ketamine infusions for reduction of suicidal ideation in treatment-resistant depression. Neuropsychopharmacology. 2020;45(4):606-612. doi:10.1038/s41386-019-0570-x
Lang UE, Borgwardt S. Molecular Mechanisms of Depression: Perspectives on New Treatment Strategies. Cell Physiol Biochem. 2013;31(6):761-777. doi:10.1159/000350094
Zanos P, Gould TD. Mechanisms of ketamine action as an antidepressant. Mol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255
Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry. 2023;28(8):3243-3256. doi:10.1038/s41380-022-01661-0
Delgado PL. Depression: The Case for a Monoamine Deficiency. J Clin Psychiatry.
Leo J, Lacasse JR. The Media and the Chemical Imbalance Theory of Depression. Society. 2008;45(1):35-45. doi:10.1007/s12115-007-9047-3
Pittenger C, Duman RS. Stress, Depression, and Neuroplasticity: A Convergence of Mechanisms. Neuropsychopharmacology. 2008;33(1):88-109. doi:10.1038/sj.npp.1301574
Albert PR. Adult neuroplasticity: A new “cure” for major depression? J Psychiatry Neurosci. 2019;44(3):147-150. doi:10.1503/jpn.190072
Huang YJ, Lane HY, Lin CH. New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plast. 2017;2017:1-11. doi:10.1155/2017/4605971
Derakhshanian S, Zhou M, Rath A, et al. Role of Ketamine in the Treatment of Psychiatric Disorders. Health Psychol Res. 2021;9(1). doi:10.52965/001c.25091
Na KS, Kim YK. Increased use of ketamine for the treatment of depression: Benefits and concerns. Prog Neuropsychopharmacol Biol Psychiatry. 2021;104:110060. doi:10.1016/j.pnpbp.2020.110060
Zhang C, Xu Y, Zhang B, Hao W, Tang WK. Cognitive impairment in chronic ketamine abusers. Psychiatry Res. 2020;291:113206. doi:10.1016/j.psychres.2020.113206
Jelen LA, Young AH, Stone JM. Ketamine: A tale of two enantiomers. J Psychopharmacol (Oxf). 2021;35(2):109-123. doi:10.1177/0269881120959644
Riggs LM, An X, Pereira EFR, Gould TD. (R,S)-ketamine and (2R,6R)-hydroxynorketamine differentially affect memory as a function of dosing frequency. Transl Psychiatry. 2021;11(1):583. doi:10.1038/s41398-021-01685-0
Abelaira HM, Réus GZ, Ignácio ZM, et al. Effects of ketamine administration on mTOR and reticulum stress signaling pathways in the brain after the infusion of rapamycin into prefrontal cortex. J Psychiatr Res. 2017;87:81-87. doi:10.1016/j.jpsychires.2016.12.002
Shen Z, Gao D, Lv X, Wang H, Yue W. A meta-analysis of the effects of ketamine on suicidal ideation in depression patients. Transl Psychiatry. 2024;14(1):248. doi:10.1038/s41398-024-02973-1
Karunarathna I, Kusumarathna K, Gunarathna I, et al. Ketamine: Mechanisms, Applications, and Future Directions.
Zhou Y, Wang C, Lan X, et al. Cognitive Function Mediates the Anti-suicide Effect of Repeated Intravenous Ketamine in Adult Patients With Suicidal Ideation. Front Psychiatry. 2022;13:779326. doi:10.3389/fpsyt.2022.779326
Murphy N, Tamman AJF, Lijffijt M, et al. Neural complexity EEG biomarkers of rapid and post-rapid ketamine effects in late-life treatment-resistant depression: a randomized control trial. Neuropsychopharmacology. 2023;48(11):1586-1593. doi:10.1038/s41386-023-01586-4
Hayley S, Litteljohn D. Neuroplasticity and the next wave of antidepressant strategies. Front Cell Neurosci. 2013;7. doi:10.3389/fncel.2013.00218
Li L, Vlisides PE. Ketamine: 50 Years of Modulating the Mind. Front Hum Neurosci. 2016;10. doi:10.3389/fnhum.2016.00612
Anand A, Mathew SJ, Sanacora G, et al. Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression. N Engl J Med. 2023;388(25):2315-2325. doi:10.1056/NEJMoa2302399
Grunebaum MF, Galfalvy HC, Choo TH, et al. Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical Trial. Am J Psychiatry. 2018;175(4):327-335. doi:10.1176/appi.ajp.2017.17060647
Kopelman J, Keller TA, Panny B, et al. Rapid neuroplasticity changes and response to intravenous ketamine: a randomized controlled trial in treatment-resistant depression. Transl Psychiatry. 2023;13(1):159. doi:10.1038/s41398-023-02451-0
Hu YD, Xiang YT, Fang JX, et al. Single i.v. ketamine augmentation of newly initiated escitalopram for major depression: results from a randomized, placebo-controlled 4-week study. Psychol Med. 2016;46(3):623-635. doi:10.1017/S0033291715002159
Nikolin S, Rodgers A, Schwaab A, et al. Ketamine for the treatment of major depression: a systematic review and meta-analysis. eClinicalMedicine. 2023;62:102127. doi:10.1016/j.eclinm.2023.102127
Shiroma PR, Thuras P, Wels J, et al. A randomized, double-blind, active placebo-controlled study of efficacy, safety, and durability of repeated vs single subanesthetic ketamine for treatment-resistant depression. Transl Psychiatry. 2020;10(1):206. doi:10.1038/s41398-020-00897-0
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Copyright (c) 2024 Weronika Szafrańska, Dominika Poborowska, Tomasz Gańko, Weronika Kahan, Emilia Bąk, Jacek Fordymacki, Marta Wojaczek, Katarzyna Polańska, Oliwia Najjar
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