Ketamine Short Term Treatment Strategies

Peter Forster Major Depression, Treatments of Depression, Uncategorized Leave a Comment

What are the best strategies for using ketamine to treat major depression in the short term? Although we know that ketamine (and, now, esketamine) can be helpful we really don’t know that much about what strategy works best. The most commonly used ketamine infusion protocol is adapted from studies using ketamine to treat chronic pain. An article in the March …

Gerard Sancora Esketamine is Effective

Intranasal Esketamine is Effective for Depression

Peter Forster Major Depression, Treatments of Depression, Uncategorized Leave a Comment

Intranasal esketamine is effective for treating severe depression and suicidality when added to comprehensive standard of care treatment in patients who were felt to be at imminent risk of suicide. 68 patients seen in an emergency department were randomized to receive esketamine or placebo as well as comprehensive treatment including inpatient care and antidepressant medications. Patients receiving esketamine had a …

Ketamine Reduces Suicidal Thoughts

Peter Forster Treatments of Depression Leave a Comment

A single infusion of ketamine reduces suicidal thoughts in depressed patients in one day, with benefits lasting for up to one week, according to a meta-analysis reported in the American Journal of Psychiatry. Further, ketamine did not seem to be just treating depression, it seemed to have an effect on suicidal thinking that was greater than its effect on depression “This suggests that …

ketamine long term effects

Long Term Effects of Ketamine

Peter Forster Major Depression, Treatments of Depression Leave a Comment

One of my patients asked me what the long term effects of ketamine are. She was particularly interested in long-term adverse effects. The last time I did a review of the literature I noted that there seem to be very little information available. This is not surprising with the psychiatric literature since ketamine and its use for chronic depression are …

Ketamine for Depression – 2017

Peter Forster Bipolar Treatment, Major Depression, Treatments of Depression

I just got back from an inspiring conference in Berkeley on Ketamine for Depression. I am eager to implement some changes in how we work with people we refer or provide ketamine infusion for that may make the treatment more effective. The conference was organized by Alison McInnes, MD, MS, who is in charge of the Kaiser, San Francisco Ketamine Treatment Program, …

Ketamine Guidelines

Peter Forster Best Practices, Treatments of Depression

Ketamine guidelines have recently been published by American Psychiatric Association Council of Research Task Force on Novel Biomarkers and Treatments. They highlight what we know and what we don’t know about this treatment. What We Know “Several studies now provide evidence of ketamine hydrochloride’s ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant …

Depression Therapeutics and Mechanisms

Peter Forster Major Depression, Psychobiology, Treatments of Depression

The September 15, 2016 edition of Biological Psychiatry is devoted to updates in the area of psychobiology that relate to depression and its treatment. In this blog post I will summarize some of those studies to give you a sense of what is going on in the field. Some of these studies may not be replicated in follow-up research, but some …

Antidepressants Alter Gene Expression

Peter Forster Major Depression, Psychobiology, Treatments of Depression

An interesting study looked at similarities and differences in the effects of two medications that have anti-depressant effects and yet are extremely different in terms of how they work: ketamine and imipramine (a tricyclic antidepressant). This industry supported study looked at the effects of these two agents on a reward circuit (involving the prefrontal cortex (PFC), nucleus accumbens, hippocampus, and amygdala – …

A Better Ketamine

Peter Forster Major Depression, Psychobiology, Treatments of Depression

A better ketamine may be coming. That is the conclusion of NEJM Journal Watch Psychiatry reviewer Barbara Geller. A common pathway to identifying new drugs, is looking at metabolites of a medication to see if there is one metabolite that works better than the active drug (desvenlafaxine – one of the metabolites of venlafaxine – may or may not be …