Depression reduction: Difference between revisions

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====Ketamine and its isomers====

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~~|Ketamine possesses a strong abuse potential at typical antidepressive doses.<ref name="KokaneArmant2020">~~{{cite journal|last1=Kokane|first1=Saurabh S.|last2=Armant|first2=Ross J.|last3=Bolaños-Guzmán|first3=Carlos A.|last4=Perrotti|first4=Linda I.|title=Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant|journal=Behavioural Brain Research|volume=384|year=2020|pages=112548|issn=01664328|doi=10.1016/j.bbr.2020.112548}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: ~~A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177~~/~~1060028019892644}~~}</ref> Ketamine has reported cases of severe bladder and liver injury. Esketamine, a newer nasal spray formulation of Ketamine, does not have any reported cases and is purported to have a better safety profile. However, in recent short-term clinical trials esketamine still more-than-doubled the amount of adverse bladder events when compared to placebo (6-10% vs 1-4%). Although 2/3 of esketamine incidents resolved themselves either without intervention or through a lowering of dosage, any physiological damage is acute and immediate: in typical dose regimens steady-state concentrations are not reached.

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Ketamine offers a (dose-dependent) large immediate depression reduction for 30-50% of patients; its effect-sizes become moderate to small by day 7.<ref name="XuHackett2016">{{cite journal|last1=Xu|first1=Ying|last2=Hackett|first2=Maree|last3=Carter|first3=Gregory|last4=Loo|first4=Colleen|last5=Gálvez|first5=Verònica|last6=Glozier|first6=Nick|last7=Glue|first7=Paul|last8=Lapidus|first8=Kyle|last9=McGirr|first9=Alexander|last10=Somogyi|first10=Andrew A.|last11=Mitchell|first11=Philip B.|last12=Rodgers|first12=Anthony|title=Effects of Low-Dose and Very Low-Dose Ketamine among Patients with Major Depression: a Systematic Review and Meta-Analysis|journal=International Journal of Neuropsychopharmacology|volume=19|issue=4|year=2016|pages=pyv124|issn=1461-1457|doi=10.1093/ijnp/pyv124}}</ref><ref name="LeeDella Selva2015">{{cite journal|last1=Lee|first1=Ellen E.|last2=Della Selva|first2=Megan P.|last3=Liu|first3=Anson|last4=Himelhoch|first4=Seth|title=Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis|journal=General Hospital Psychiatry|volume=37|issue=2|year=2015|pages=178–184|issn=01638343|doi=10.1016/j.genhosppsych.2015.01.003}}</ref><ref name="PennybakerNiciu2017">{{cite journal|last1=Pennybaker|first1=Steven J.|last2=Niciu|first2=Mark J.|last3=Luckenbaugh|first3=David A.|last4=Zarate|first4=Carlos A.|title=Symptomatology and predictors of antidepressant efficacy in extended responders to a single ketamine infusion|journal=Journal of Affective Disorders|volume=208|year=2017|pages=560–566|issn=01650327|doi=10.1016/j.jad.2016.10.026}}</ref> Weekly to biweekly dosing maintains a statistically significant depression reduction measured at Day 28 and repeated administration has resulted in cases of euthymia.<ref name="RyanMarta2014">{{cite journal|last1=Ryan|first1=Wesley C.|last2=Marta|first2=Cole J.|last3=Koek|first3=Ralph J. |title=Ketamine and Depression: A Review|journal=International Journal of Transpersonal Studies|volume=33|issue=2|year=2014|pages=40–74|issn=13210122|doi=10.24972/ijts.2014.33.2.40}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177/1060028019892644}}</ref> A family history of alcohol-use-disorder in a first-degree relative is associated with an improved antidepressive response, and a reduction of adverse mental effects such as [[cognitive dysphoria|dysphoria]]. Its antidepressant properties may also stem more generally from dissociatives' [[novelty enhancement|novelty]] and/or [[immersion enhancement|immersion enhancements]].

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 ====Ketamine and its isomers====
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+{{Template:Warning/Ketamine}}
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-|Ketamine possesses a strong abuse potential at typical antidepressive doses.<ref name="KokaneArmant2020">{{cite journal|last1=Kokane|first1=Saurabh S.|last2=Armant|first2=Ross J.|last3=Bolaños-Guzmán|first3=Carlos A.|last4=Perrotti|first4=Linda I.|title=Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant|journal=Behavioural Brain Research|volume=384|year=2020|pages=112548|issn=01664328|doi=10.1016/j.bbr.2020.112548}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177/1060028019892644}}</ref> Ketamine has reported cases of severe bladder and liver injury. Esketamine, a newer nasal spray formulation of Ketamine, does not have any reported cases and is purported to have a better safety profile. However, in recent short-term clinical trials esketamine still more-than-doubled the amount of adverse bladder events when compared to placebo (6-10% vs 1-4%).  Although 2/3 of esketamine incidents resolved themselves either without intervention or through a lowering of dosage, any physiological damage is acute and immediate: in typical dose regimens steady-state concentrations are not reached.
-|}
 Ketamine offers a (dose-dependent) large immediate depression reduction for 30-50% of patients; its effect-sizes become moderate to small by day 7.<ref name="XuHackett2016">{{cite journal|last1=Xu|first1=Ying|last2=Hackett|first2=Maree|last3=Carter|first3=Gregory|last4=Loo|first4=Colleen|last5=Gálvez|first5=Verònica|last6=Glozier|first6=Nick|last7=Glue|first7=Paul|last8=Lapidus|first8=Kyle|last9=McGirr|first9=Alexander|last10=Somogyi|first10=Andrew A.|last11=Mitchell|first11=Philip B.|last12=Rodgers|first12=Anthony|title=Effects of Low-Dose and Very Low-Dose Ketamine among Patients with Major Depression: a Systematic Review and Meta-Analysis|journal=International Journal of Neuropsychopharmacology|volume=19|issue=4|year=2016|pages=pyv124|issn=1461-1457|doi=10.1093/ijnp/pyv124}}</ref><ref name="LeeDella Selva2015">{{cite journal|last1=Lee|first1=Ellen E.|last2=Della Selva|first2=Megan P.|last3=Liu|first3=Anson|last4=Himelhoch|first4=Seth|title=Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis|journal=General Hospital Psychiatry|volume=37|issue=2|year=2015|pages=178–184|issn=01638343|doi=10.1016/j.genhosppsych.2015.01.003}}</ref><ref name="PennybakerNiciu2017">{{cite journal|last1=Pennybaker|first1=Steven J.|last2=Niciu|first2=Mark J.|last3=Luckenbaugh|first3=David A.|last4=Zarate|first4=Carlos A.|title=Symptomatology and predictors of antidepressant efficacy in extended responders to a single ketamine infusion|journal=Journal of Affective Disorders|volume=208|year=2017|pages=560–566|issn=01650327|doi=10.1016/j.jad.2016.10.026}}</ref> Weekly to biweekly dosing maintains a statistically significant depression reduction measured at Day 28 and repeated administration has resulted in cases of euthymia.<ref name="RyanMarta2014">{{cite journal|last1=Ryan|first1=Wesley C.|last2=Marta|first2=Cole J.|last3=Koek|first3=Ralph J. |title=Ketamine and Depression: A Review|journal=International Journal of Transpersonal Studies|volume=33|issue=2|year=2014|pages=40–74|issn=13210122|doi=10.24972/ijts.2014.33.2.40}}</ref><ref name="BozymskiCrouse2019">{{cite journal|last1=Bozymski|first1=Kevin M.|last2=Crouse|first2=Ericka L.|last3=Titus-Lay|first3=Erika N.|last4=Ott|first4=Carol A.|last5=Nofziger|first5=Jill L.|last6=Kirkwood|first6=Cynthia K.|title=Esketamine: A Novel Option for Treatment-Resistant Depression|journal=Annals of Pharmacotherapy|volume=54|issue=6|year=2019|pages=567–576|issn=1060-0280|doi=10.1177/1060028019892644}}</ref> A family history of alcohol-use-disorder in a first-degree relative is associated with an improved antidepressive response, and a reduction of adverse mental effects such as [[cognitive dysphoria|dysphoria]]. Its antidepressant properties may also stem more generally from dissociatives' [[novelty enhancement|novelty]] and/or [[immersion enhancement|immersion enhancements]].