Ketamine in Major Depressive Disorder: Mechanisms and Future Perspectives.

Ketamine in Major Depressive Disorder: Mechanisms and Future Perspectives. Psychiatry Investig. 2020 Mar;17(3):181-192 Authors: Shin C, Kim YK Abstract Major depressive disorder (MDD) is a serious psychiatric illness that causes functional impairment in many people. While monoaminergic antidepressants have been used to effectively treat MDD, these antidepressants have limitations in that they have delayed onset of action and many patients remain treatment-resistant. Therefore, there is a need to develop antidepressants with a novel target, and researchers have directed their attention to the glutamatergic system. Ketamine, although developed as an anesthetic, has been found to produce an antidepressant effect at sub-anesthetic doses via N-Methyl-D-aspartic acid (NMDA) receptor blockade as well as NMDA receptor- independent pathways. A single infusion of ketamine produced rapid improvement in clinical symptoms to a considerable level and led to the resolution of serious depressive symptoms, including imminent suicidal ideation, in patients with MDD. A series of recent randomized controlled trials have provided a high level of evidence for the therapeutic efficacy of ketamine treatment in MDD and presented new insights on the dose, usage, and route of administration of ketamine as an antidepressant. With this knowledge, it is expected that ketamine treatment protocols for MDD will be established as a treatment option available in clinical practice. However,...
Source: Psychiatry Investigation - Category: Psychiatry Tags: Psychiatry Investig Source Type: research

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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Explainer feature Londontime Source Type: news
We describe the historical use of opioids and the scope of the current opioid crisis, review the differences between dependence and addiction, and the private and public sectors response to pain management and highlight the issue of adolescent vulnerability. We conclude with a proposal for future directions that address both public and patient health needs.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Jorge A. Gálvez Source Type: research
Authors: Abstract Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with l...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research
Authors: Abstract Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with l...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research
I was offered an out of match fellowship position and accepted it 2 days ago. Now, due to family issues It would not be ideal for me to relocate to that area. Is there a way I can withdraw my acceptance (I haven’t sign the intent letter or anything whatsoever, just email agreement) or would it be profesional suicide?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums
cGPA: 3.93 sGPA: 3.90 MCAT: 515 Major: Speech, Language, and Hearing Sciences MA resident (becoming an SC resident in July 2020), ORM Activities: Clinical experience Worked as a mental health assistant in a locked psych unit for a summer between semesters for about 370 hours. Had to do patient intake screenings, do wellness checks on patients every 15 mins, record patient notes for incoming staff, do one-on-one suicide watches, etc. Started working as an anesthesia tech 2... WAMC/Looking for school list help from my fellow quarantinees
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: What Are My Chances? WAMC Medical Source Type: forums
N-methyl-d-aspartate receptor (NMDAR) antagonists, including ketamine and nitrous oxide, are currently intensely studied as rapid-acting antidepressant agents. Interestingly, both of these compounds are also drugs of abuse.Intravenous ketamine, a dissociative anesthetic that induces complex downstream effects via NMDARs, rapidly reduces depressive and suicidal symptoms in treatment-resistant depression (TRD), as demonstrated by several trials. Recently, the United States Food and Drug Administration (FDA) approved an intranasal version of ketamine (esketamine) for TRD.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Review Article Source Type: research
Objectives It remains controversial whether a subanesthetic dose of ketamine could modulate the antidepressant effect of electroconvulsive therapy (ECT) in patients with major depressive disorder. We investigated the effect of ketamine on accelerating the antidepressant efficacy of ECT. Methods One hundred twenty-seven patients with major depressive disorder were included in this randomized, placebo-controlled, double-blind study. The study group received 0.3 mg/kg ketamine, and the control group received an isovolumetric dose of normal saline before undergoing ECT under propofol anesthesia. The main outcome was the H...
Source: The Journal of ECT - Category: Psychiatry Tags: Original Studies Source Type: research
By GREG HAMMER, MD Burnout among healthcare professionals is at an all-time high. Its drivers include longer work hours, the push to see more patients, more scrutiny by administrators, and loss of control over our practice. We seem to spend more time with the electronic medical record and less time face-to-face with our patients. I have faced burnout personally. My son passed away at the age of 29, which was beyond painful. At the same time, I felt burdened by the growing number and complexity of metrics by which I was judged at work. Days in the operating room and intensive care unit seemed more and more exhausting,...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Physicians Burnout GAIN GAIN without Pain: The Happiness Handbook for Health Care Professionals Greg Hammer physician burnout physician wellness Source Type: blogs
Perrotti LI Abstract Ketamine, a dissociative anesthetic and psychedelic compound, has revolutionized the field of psychopharmacology by showing robust, and rapid-acting antidepressant activity in patients suffering from major depressive disorder (MDD), suicidal tendencies, and treatment-resistant depression (TRD). Ketamine's efficacy, however, is transient, and patients must return to the clinic for repeated treatment as they experience relapse. This is cause for concern because ketamine is known for its abuse liability, and repeated exposure to drugs of abuse often leads to drug abuse/dependence. Though the mech...
Source: Behavioural Brain Research - Category: Neurology Authors: Tags: Behav Brain Res Source Type: research
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