Electroconvulsive Therapy: A Primer

Topics: brief pulse | Depression | ECT | Innovations | Ketamine | maintenance ECT | memory loss | retrograde amnesia | Stigma | Suicidality | TMS | unilateral vs bilateral

CHPR: Welcome, Dr. Seiner. Can you tell us what led to your interest in electroconvulsive therapy (ECT) and neurotherapeutics? Dr. Seiner: I went to the University of Michigan and got a degree in chemical engineering, but I decided I didn’t want to fractionate oil for a living, so I went to medical school thinking I would be an internist. While in me

Intravenous Ketamine for Teen Depression

Topics: adolescents | Depression | Free Articles | Ketamine | Suicidality

REVIEW OF: Dwyer JB et al, Am J Psychiatry 2021;178(4):352–362 TYPE OF STUDY: Randomized midazolam-controlled trial Treatment-resistant depression (TRD) is a growing concern in teenagers. Although intravenous ketamine has shown clear and immediate improvement of TRD in adults, there is little research to show its effectiveness in teens, and each

Psilocybin: The New Holy Grai­l for the Rapid Relief of Major ­Depression?

Topics: Depression | Ketamine | Mood | Pharmacotherapy | Psilocybin | Rapid-acting

Review of: Davis AK et al, JAMA ­Psychiatry 2020:e203285 Intravenous ketamine and intranasal esketamine (Spravato) offer hope in the search for a rapidly acting antidepressant. However, concerns regarding addiction, safety, and effect durability have prompted searches for alternative rapid-acting treatments. Psilocybin is a hallucinogen originally d

Intranasal Esketamine: New Hope for Suicidal Patients?

Topics: Depression | Esketamine | Fast-acting | Free Articles | Intra-nasal | Ketamine | Management | Psychopharmacology | Suicidality

It’s likely your patients have asked you about esketamine. The buzz is that it’s a rapid-acting miracle cure for suicidal depression. Dr. Thomas Insel, former director of NIMH, declared that ketamine “might be the most important breakthrough in antidepressant treatment in decades” (www.nimh.nih.gov/about/directors/thomas-insel/blog/2014/ketamine

Getting Uncomfortable with Esketamine

Topics: Antidepressant Augmentation | Antidepressants | Brain Devices | Depression | Depressive Disorder | ECT | Esketamine | Free Articles | Ketamine | Neurotoxicity | Novel Medications | rTMS | Suicidality | TMS | Transcranial Magnetic Stimulation | Treatment-Resistant Depression

Esketamine (Spravato) was approved for treatment-resistant depression in 2019. In this interview, Dr. Williams (who has no relationship with Janssen Pharmaceuticals, Inc) addresses some lingering doubts that have been raised about the medicine. TCPR: Where does esketamine fit in the list of interventional therapies for depression, like repetitive tra

Pilot Study of Ketamine vs ECT for Major Depression

Topics: ECT | Esketamine | Ketamine | Suicide | Treatment-Resistant Depression

REVIEW OF: Kheirabadi D et al, J Clin Psychopharm 2020;40(6):588–593 STUDY TYPE: Randomized controlled trial Electroconvulsive therapy (ECT) has long been the gold standard for severe or treatment-refractory depression (TRD). However, it has two major drawbacks: it involves anesthesia and it may be associated with memory impairment. Ketamine has

Is Ketamine Just Another Opiate?

Topics: Antidepressants | Depression | Ketamine | Opioids | Research Update

Review of: Williams NR et al, Am J Psychiatry 2018;175:1–11 Type of study: Double-blind, placebo-controlled, crossover study Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsib