Cells
February 12, 2022
Alina Wilkowska, Mariusz S. Wiglusz, Katarzyna Jakuszkowiak‐wojten et al.
23 citations
A review of animal and human studies on combining ketamine with lamotrigine found that animal models suggested a synergistic antidepressant effect, while studies in healthy humans showed lamotrigine pretreatment reduced ketamine-induced dissociative symptoms. In a study of depressed patients, a single ketamine infusion combined with lamotrigine did not produce a stronger antidepressant effect than ketamine alone. A case series described antidepressant and anti-suicidal effects in two bipolar patients. Clinical studies in mood disorder patients did not support lamotrigine reducing ketamine-induced dissociation. The available evidence was insufficient to answer the review's questions, but pointed to future research directions, including controlled studies in bipolar patients with multiple ketamine infusions.
Brain Sciences
January 13, 2023
Maria Gałuszko‐węgielnik, Zuzanna Chmielewska, Katarzyna Jakuszkowiak‐wojten et al.
20 citations
Psychotic treatment-resistant depression is a severe form of major depressive disorder involving hallucinations or delusions, often underdiagnosed and undertreated. Ketamine has shown rapid antidepressant effects, and its enantiomer esketamine was approved for treatment-resistant depression in 2019. This report describes four inpatients with treatment-resistant depression and psychotic features, including one in severe suicidal crisis, who received a single 0.5 mg/kg intravenous infusion of ketamine as an add-on to standard care. Monitoring showed no worsening of psychotic symptoms in short or long term, and all patients achieved stable remission with an immediate antisuicidal effect. Ketamine may benefit individuals with this condition.
Bipolar Disorders
February 4, 2024
Alina Wilkowska, Mariusz S. Wiglusz, Aleksandra Arciszewska et al.
17 citations
In patients with treatment-resistant bipolar depression, adding ketamine infusions to ongoing treatment reduced anhedonia, a debilitating symptom linked to suicidality and poor treatment response. Improvement was seen on both patient-reported and clinician-rated measures of anhedonia, and anxiety and mood/cognition symptoms also improved, but sleep symptoms did not. No serious adverse events occurred. The findings suggest ketamine may be a useful option for anhedonia in this population, though further research is needed.
Frontiers in Psychiatry
June 3, 2020
Alina Wilkowska, Łukasz P. Szałach, Jakub Słupski et al.
9 citations
Ketamine can rapidly reduce depression in people with treatment-resistant bipolar disorder, but it also carries a risk of triggering mania. This case describes a patient with bipolar I disorder who, after eight low doses of oral ketamine added to their usual treatment, switched from a depressive episode to a manic episode with mixed features. The manic symptoms began two days before the switch became full-blown. The finding highlights the need for careful monitoring of mood changes when using ketamine in bipolar depression.
Frontiers in Neuroscience
July 11, 2023
Maria Gałuszko‐węgielnik, Katarzyna Jakuszkowiak‐wojten, Mariusz S. Wiglusz et al.
8 citations
In patients with treatment-resistant unipolar or bipolar depression with psychotic features, eight intravenous infusions of 0.5 mg/kg ketamine given twice a week over 4 weeks did not worsen psychotic or dissociative symptoms. No statistically significant changes occurred in depressive, dissociative, or psychomimetic symptom scores across the whole group during treatment. However, within the unipolar and bipolar subgroups separately, significant improvements in these symptom scores were observed. The findings support the safety and tolerability of ketamine in this population, showing no exacerbation of psychotic symptoms.
Pharmaceuticals
May 3, 2021
Natalia Górska, Wiesław Jerzy Cubała, Jakub Słupski et al.
2 citations
Magnesium levels in the blood change over the course of ketamine treatment for depression. In patients with major depressive disorder or bipolar disorder, serum magnesium concentration was significantly higher before treatment began than after five or seven ketamine infusions. However, changes in magnesium levels were not correlated with depression scores on the Montgomery-Åsberg Depression Rating Scale (MADRS) or with mania scores on the Young Mania Rating Scale (YMRS). The study also found no link between magnesium concentration and somatic comorbidities. While the findings support the idea that magnesium plays a role in treatment-resistant depression, especially with ketamine, there is no clear evidence of a straightforward relationship between magnesium levels and treatment response or other health conditions.
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
1 citation
In patients with treatment-resistant depression, intravenous ketamine appears safe regarding dissociative and psychotic symptoms, but those with epilepsy require close monitoring. Among 49 inpatients with major depressive or bipolar disorder and somatic comorbidities, psychotic symptom scores changed significantly over time only in the epilepsy subgroup. For other somatic conditions, no significant psychotic symptom changes occurred regardless of depression diagnosis. The study was small, unblinded, and limited to a single site, so findings are preliminary.
Research Square (Research Square)
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
In hospitalized patients with treatment-resistant depression (major depressive or bipolar disorder), intravenous ketamine treatment was associated with changes in psychotic symptoms over time among those with epilepsy, but not among those with other somatic conditions. The study, which included 49 participants and was limited by a small, unblinded, single-site design, suggests that careful monitoring for psychotic symptoms is needed when using ketamine in patients with epilepsy, and that somatic comorbidities may influence dissociative side effects.