Comparative metabolomic analysis in plasma and cerebrospinal fluid of humans and in plasma and brain of mice following antidepressant-dose ketamine administration.

Subanesthetic-dose racemic (R,S)-ketamine (ketamine) produces rapid, robust, and sustained antidepressant effects in major depressive disorder (MDD) and bipolar disorder (BD) and has also been shown to effectively treat neuropathic pain, complex regional pain syndrome, and post-traumatic stress disorder (PTSD). However, to date, its mechanism of action remains unclear. Preclinical studies found that (2 R,6 R;2 S,6 S)-hydroxynorketamine (HNK), a major circulating metabolite of ketamine, elicits antidepressant effects similar to those of ketamine.

Drug Development for Mental Illness: How Psychiatry Clinical Trial Sites are Meeting the Challenge of the COVID-19 Pandemic.

The goal was to review the impact of the COVID-19 pandemic on psychiatric drug development and clinical trials. Disruption of pharmaceutical industry- sponsored clinical trials for psychiatric disorders by the COVID-19 pandemic, prompted by concerns regarding the safety of trial participants and the feasibility of trial conduct, has adversely impacted psychiatric drug development. In response, psychiatry trial sites have modified clinical trials and adapted trial conduct, through the use of social distancing, personal protective equipment, laboratory testing, and remote assessments, to reduce the risks of COVID-19.

Can 'floating' predict treatment response to ketamine? Data from three randomized trials of individuals with treatment-resistant depression.

Ketamine has rapid-acting antidepressant properties but also potentially concerning transient dissociative side effects (SEs). Recent studies noted a positive correlation between treatment response to ketamine and general dissociative SEs, as well as "floating", a depersonalization SE (a subtype of the dissociative SEs). This analysis sought to determine whether floating mediates treatment response to ketamine.

Comprehensive assessment of side effects associated with a single dose of ketamine in treatment-resistant depression.

Background: Concerns about ketamine for treating depression include abuse potential and the occurrence of psychotomimetic effects. This study sought to comprehensively assess side effects (SEs) associated with a single subanesthetic-dose intravenous ketamine infusion. A secondary aim was to examine the relationship between Clinician-Administered Dissociative States Scale (CADSS) scores and dissociative symptoms reported on a comprehensive, clinician-administered SE questionnaire.

Challenges of managing delirium and catatonia in a medically ill patient.

Background: Untangling catatonia and delirium can be challenging. Furthermore, treatment of one syndrome can potentially worsen another.

Case Presentation: We present the case of a 71-year-old patient with a history of schizoaffective disorder, bipolar subtype, who developed catatonia and delirium with prominent psychotic symptoms, during a single hospitalization.