Ketamine for Depression: Is the Hype Holding Up? Mechanisms and Evidence-View Presentation

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Video Summary

In this video presentation, Dr. Richard Shelton discusses the topic of ketamine for depression. He acknowledges the awareness of ketamine treatment for depression and delves into its mechanism and potential benefits for treating depression. Dr. Shelton presents evidence from various studies, including controversies surrounding the treatment. He credits the American Psychiatric Association (APA) and the program committee for inviting him to present at the conference. He also acknowledges grants from NIH and collaborations with Janssen Pharmaceuticals. Dr. Shelton discusses the mechanisms of how the brain regulates emotion and explains the effects of ketamine on the brain. He highlights the positive effects of ketamine and S-ketamine on depression and suicidal ideation, as well as potential risks and limitations. <br /><br />In another video, the speaker focuses on esketamine, a derivative of ketamine, for the treatment of treatment-resistant depression (TRD) and major depressive disorder with suicidal ideation (MDDSI). They discuss the effectiveness of esketamine, presenting data from clinical trials showing a significant reduction in depressive symptoms. However, concerns regarding rapid response, patient population inclusion, safety trials, and unblinding are mentioned. The speaker explores the interaction between esketamine and opioid receptors and suggests that its antidepressant benefit may not solely be due to opioid receptor activation. Practical issues related to administration, reimbursement, and post-discharge treatment of esketamine are discussed. Ongoing research on other glutamate-targeting compounds and their potential efficacy for TRD, bipolar depression, and PTSD is mentioned. The speaker concludes by discussing the placement of esketamine in the treatment algorithm for depression and highlights the challenges associated with its clinical use and reimbursement.

Keywords

ketamine

depression

ketamine treatment

mechanism

benefits

studies

controversies

esketamine

treatment-resistant depression

clinical trials

opioid receptors