Evidence-Based Reviews

Top research findings of 2018-2019 for clinical practice

Author and Disclosure Information

 

References

Conclusion

  • In patients with TRD who responded to initial treatment with esketamine, continuing esketamine plus an oral antidepressant resulted in clinically meaningful superiority in preventing relapse compared with a placebo nasal spray plus an oral antidepressant.

3. Williams NR, Heifets BD, Blasey C, et al. Attenuation of antidepressant effects of ketamine by opioid receptor antagonism. Am J Psychiatry. 2018;175(12):1205-1215.

Many studies have documented the efficacy of ketamine as a rapid-onset antidepressant. Studies investigating the mechanism of this effect have focused on antagonism of N-methyl-D-aspartate (NMDA) receptors. However, several clinical trials that attempted to replicate this rapid antidepressant effect with other NMDA receptor antagonists had only limited success. Williams et al3 conducted the first human study that presents evidence that opioid receptor activation may be necessary for ketamine’s acute antidepressant effect.

Study design

  • This double-blind crossover study evaluated if opioid receptor activation is necessary for ketamine to have an antidepressant effect in patients with TRD.
  • Twelve participants completed both sides of the study in a randomized order. Participants received placebo or naltrexone prior to an IV infusion of ketamine.
  • Researchers measured patients’ scores on the Hamilton Depression Rating Scale (HAM-D) at baseline and 1 day after infusion. Response was defined as a ≥50% reduction in HAM-D score.

Outcomes

  • Reductions in HAM-D scores among participants in the ketamine plus naltrexone group were significantly lower than those of participants in the ketamine plus placebo group.
  • Dissociation related to ketamine use did not differ significantly between the naltrexone group and the placebo group.

Continue to: Conclusion

Pages

Recommended Reading

#MomsNeedToKnow mental health awareness campaign set to launch
Journal of Clinical Outcomes Management
Suicide attempts up in black U.S. teens
Journal of Clinical Outcomes Management
State medical boards under fire in physician suicides
Journal of Clinical Outcomes Management
Evidence lacking for using cannabinoids to treat mental disorders
Journal of Clinical Outcomes Management
Reappraising standard treatment of comorbid insomnia/depression
Journal of Clinical Outcomes Management
Suicide screening crucial in pediatric medical settings
Journal of Clinical Outcomes Management
Depression linked to persistent opioid use after hysterectomy
Journal of Clinical Outcomes Management
Black-box warnings: How they can improve your clinical practice
Journal of Clinical Outcomes Management
ACGME deepening its commitment to physician well-being, leader says
Journal of Clinical Outcomes Management
Higher risk of bipolar disorder, depression, anxiety found with autism
Journal of Clinical Outcomes Management