Rapid-acting Antidepressants: New treatments, New Hope, and New Insights Into the Brain-View Presentation

Video Transcription

Video Summary

In this video, Dr. John Crystal, Chair of the Department of Psychiatry at Yale University, discusses the use of ketamine and esketamine as rapid-acting antidepressants. He mentions that ketamine and esketamine are effective in treating treatment-resistant depression and depression in the context of elevated suicide risk. The administration of ketamine is typically done intravenously at a dose of 0.5 milligrams per kilogram over 40 minutes, while esketamine is administered intranasally at a starting dose of 56 milligrams. Dr. Crystal explains that ketamine works by blocking NMDA glutamate receptors, which leads to increased release of glutamate and activation of AMPA and NMDA glutamate receptors, ultimately resulting in the regrowth of dendritic spines and synapses. He also discusses the challenges with current antidepressants, the potential use of ketamine in other psychiatric disorders such as bipolar depression and PTSD, and the safety and tolerability of ketamine. Additionally, he touches on the importance of combining ketamine with psychotherapies and the potential use of other drugs that target similar pathways as ketamine for the treatment of depression. Overall, Dr. Crystal emphasizes the hope and promise that ketamine and esketamine offer in treating depression and the need for further research in optimizing their use. The video was part of a webinar presented by the American Psychiatric Association's Emerging Topics webinar series and provided physician CME credits.

Keywords

ketamine

esketamine

rapid-acting antidepressants

treatment-resistant depression

intravenous administration

intranasal administration

NMDA glutamate receptors

dendritic spines

bipolar depression

PTSD

safety and tolerability

psychotherapies