Ketamine For Treatment Resistant Depression

This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine and second-generation “ketamine-like” fast-acting antidepressants. Currently available antidepressant medications act through monoaminergic systems, are ineffective for many individuals suffering from depression, and are associated with a delayed onset of peak efficacy of several months. The unexpected emergence of ketamine, an anesthetic N-methyl-D-aspartate (NMDA) receptor antagonist, as a rapid-acting antidepressant has reinvigorated CNS drug discovery research and catalyzed investigation in patient populations historically ignored in antidepressant drug development programs, particularly treatment-resistant patients and those with suicidality. Recent industry and academic research efforts have coalesced to explore NMDA receptor and glutamatergic molecular targets that lack ketamine’s psychotomimetic side effects and abuse liability but retain its rapid onset of efficacy. However, many fundamental questions remain regarding the neurobiological mechanisms underlying ketamine’s rapid antidepressant effects and the puzzling persistence of benefits observed in some patients following a single dose. This book examines how insights from these studies are forging new conceptual models of the neurobiology of stress-related affective, anxiety, and addictive disorders and the nature of treatment resistance. It also discusses how ketamine’s rapid antidepressant effects provide a scientific platform to facilitate innovation in clinical trial designs pertaining to patient selection, choice of control group, outcome measures, and dose-optimization. This book brings together data and insights from this rapidly expanding and extraordinarily promising field of study. Readers will be able to extract integrated themes and useful insights from the material contained in these diverse chapters and appreciate the paradigm-shifting contributions of ketamine to modern psychiatry and clinical neuroscience research.

Ketamine for Treatment-Resistant Depression: Neurobiology and Applications provides a simple, evidence-based overview for neuropsychiatrists and translational researchers on this medication, its mechanisms of actions, eligibility of patients for treatment, and the preparation and implementation of ketamine clinics. Provides efficacy research on ketamine as a treatment for depression Identifies best practices for clinical use, both long-term and acute Discusses the molecular mechanisms and neurobiology of action

Given the unacceptably high rates of suffering, disability and premature death experienced by people with treatment-resistant depression and the surprisingly low rates of problems arising from the use of ketamine to treat the disorder, this is a therapy that all patients and their doctors should be discussing. This book summarises the research that has been carried out into ketamine for the treatment of depression over the past 15 years and, most importantly, describes different ways of using ketamine that are both practical and cost–effective. Currently most ketamine therapy is given intravenously in specialised clinics at considerable expense, but the author has successfully treated patients with low-dose sublingual ketamine and his patients have been able to safely take this at home. Profits from the sales of this book will assist further research into the use of ketamine for the treatment of depression.

The Advances in Pharmacology series presents a variety of chapters from the best authors in the field. Includes the authority and expertise of leading contributors in pharmacology Presents the latest release in the Advances in Pharmacology series

Managing Treatment-Resistant Depression: Road to Novel Therapeutics defines TRD for readers, discussing the clinical and epidemiological predictors, economic burden and neurobiological factors. In addition, staging methods for treatment resistance are fully covered in this book, including serotonin specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, other classes of antidepressants, including tricyclic antidepressants and monoamine oxidase inhibitors, augmentation strategies, and newer antidepressant treatments like ketamine and esketamine. In addition, evidence supporting the use of psychotherapies and neuromodulation strategies are also reviewed. Written by top experts in the field, this book is the first of its kind to review all methods of treatment for TRD. Defines Treatment-Resistant Depression and Staging Treatment Intensity Includes Treatment-Resistant Depression options for children, adolescents, geriatrics, during pregnancy, and during post-partum and menopause transitions Discusses the use of Ketamine and Esketamine for treatment-resistant depression

Treatment-resistant major depression and bipolar disorder are highly prevalent and disabling conditions associated with substantial morbidity and mortality. Providing a concise view of the current definitions, assessment and evidence-based management of such disorders, this work reviews novel therapeutic targets, which may enhance the future therapeutic armamentarium of clinicians.

This book presents the latest data from basic research and clinical trials supporting the effectiveness of ketamine as a treatment for depression, bipolar disorder, and suicidal behavior, setting these positive findings within the context of the serious problem of ketamine abuse. The first part of the book focuses on the evidence regarding ketamine abuse, with specific reference to Asian countries, and discusses countermeasures and complication management. It then addresses the mechanisms underlying the antidepressant and side effects of ketamine, which have remained elusive, describing and discussing important new research findings. Further, it explains insights gained from whole brain imaging in rodents and from behavioral pharmacology, and presents evidence regarding the role of gut microbiota, the NMDA receptor GluN2D subunit, and the lateral habenula in the actions of ketamine. These advances form the basis for the safer use of ketamine in patients with treatment-resistant depression and are expected to lead to the development of new antidepressants.

Am I depressed or just unhappy? In the last two decades, antidepressants have become staples of our medicine cabinets—doctors now write 120 million prescriptions annually, at a cost of more than 10 billion dollars. At the same time, depression rates have skyrocketed; twenty percent of Americans are now expected to suffer from it during their lives. Doctors, and drug companies, claim that this convergence is a public health triumph: the recognition and treatment of an under-diagnosed illness. Gary Greenberg, a practicing therapist and longtime depressive, raises a more disturbing possibility: that the disease has been manufactured to suit (and sell) the cure. Greenberg draws on sources ranging from the Bible to current medical journals to show how the idea that unhappiness is an illness has been packaged and sold by brilliant scientists and shrewd marketing experts—and why it has been so successful. Part memoir, part intellectual history, part exposé—including a vivid chronicle of his participation in a clinical antidepressant trial—Manufacturing Depression is an incisive look at an epidemic that has changed the way we have come to think of ourselves.