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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Synthesizing the evidence for ketamine and esketamine in treatment-resistant depression: An international expert opinion on the available evidence and implementation
American Journal of Psychiatry, Volume 178, No. 5, Year 2021
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Description
Replicated international studies have underscored the human and societal costs associated with major depressive disorder. Despite the proven efficacy of monoamine-based antidepressants in major depression, the majority of treated individuals fail to achieve full syndromal and functional recovery with the index and subsequent pharmacological treatments. Ketamine and esketamine represent pharmacologically novel treatment avenues for adults with treatment-resistant depression. In addition to providing hope to affected persons, these agents represent the first nonmonoaminergic agents with proven rapid-onset efficacy in major depressive disorder. Nevertheless, concerns remain about the safety and tolerability of ketamine and esketamine in mood disorders. Moreover, there is uncertainty about the appropriate position of these agents in treatment algorithms, their comparative effectiveness, and the appropriate setting, infrastructure, and personnel required for their competent and safe implementation. In this article, an international group of mood disorder experts provides a synthesis of the literature with respect to the efficacy, safety, and tolerability of ketamine and esketamine in adults with treatment-resistant depression. The authors also provide guidance for the implementation of these agents in clinical practice, with particular attention to practice parameters at point of care. Areas of consensus and future research vistas are discussed. © 2021 American Psychiatric Association. All rights reserved.
Authors & Co-Authors
Mcintyre, Roger S.
Canada, Toronto
University Health Network University of Toronto
Canada, Toronto
University of Toronto
Rosenblat, Joshua D.
Canada, Toronto
University Health Network University of Toronto
Canada, Toronto
University of Toronto
Nemeroff, Charles B.
United States, Austin
The University of Texas at Austin
Sanacora, Gerard S.
United States, New Haven
Yale School of Medicine
Berk, Michael
Australia, Geelong
Barwon Health
Australia, Melbourne
Orygen Youth Health
Dodd, Seetal M.
Australia, Geelong
Barwon Health
Australia, Melbourne
University of Melbourne
Gorwood, Philip A.P.M.
France, Paris
Institut de Psychiatrie et Neurosciences de Paris Ipnp
Iosifescu, Dan Vlad
United States, Orangeburg
Nathan S. Kline Institute for Psychiatric Research
Kasper, Siegfried F.
Austria, Vienna
Medizinische Universität Wien
Thase, Michael E.
United States
Va Medical Center
Vieta, Eduard
Spain, Barcelona
Institut D'investigacions Biomèdiques August pi I Sunyer - Idibaps
Young, Allan H.
United Kingdom, London
South London and Maudsley Nhs Foundation Trust
Zarate, Carlos A.
United States, Bethesda
Instituto Nacional de la Salud Mental
Statistics
Citations: 223
Authors: 13
Affiliations: 22
Identifiers
Doi:
10.1176/appi.ajp.2020.20081251
ISSN:
0002953X
Research Areas
Mental Health
Substance Abuse