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Brain Volume In Chronic Ketamine Users - Relationship To Sub-Threshold Psychotic Symptoms And Relevance To Schizophrenia, Robert A Chesters, Fiona Pepper, Celia Morgan, Jonathan D Cooper, Oliver D Howes, Anthony C Vernon, James M Stone

2020-Current year OA Pubs

RATIONALE: Ketamine may model aspects of schizophrenia arising through NMDA receptor activity deficits. Although acute ketamine can induce effects resembling both positive and negative psychotic symptoms, chronic use may be a closer model of idiopathic psychosis.

OBJECTIVES: We tested the hypotheses that ketamine users had lower brain volumes, as measured using MRI, and greater sub-threshold psychotic symptoms relative to a poly-drug user control group.

METHODS: Ketamine users (n = 17) and poly-drug using controls (n = 19) were included in the study. All underwent volumetric MRI imaging and measurement of sub-threshold psychotic symptoms using the Comprehensive Assessment of At-Risk Mental …

A Randomized Feasibility Pilot-Study Of Intravenous And Subcutaneous Administration Of Ketamine To Prevent Postpartum Depression After Planned Cesarean Delivery Under Neuraxial Anesthesia, David Thomas Monks, Arvind Palanisamy, Danish Jaffer, Preet Mohinder Singh, Ebony Carter, Shannon Lenze

2020-Current year OA Pubs

BACKGROUND: Evidence suggests ketamine may prevent postpartum depression (PPD) after cesarean delivery (CD) although intolerability and inconvenience of administration are problematic. We assessed the feasibility of studying ketamine (0.5 mg/kg, via subcutaneous injection or 40-min intravenous infusion) to prevent PPD after CD.

METHODS: Twenty-three women scheduled for cesarean delivery under neuraxial anesthesia were randomized to one of three groups: subcutaneous ketamine (SC Group, n = 8), intravenous ketamine (IV Group, n = 8) or placebo (n = 7). We measured depression (Edinburgh Postpartum Depression Scale [EPDS]) scores pre-operatively and at 1, 2, 21 and 42 days postoperatively. Anxiety, adverse effects, …

Non-Sedative Cortical Eeg Signatures Of Allopregnanolone And Functional Comparators, Peter M Lambert, Richard Ni, Ann Benz, Nicholas R Rensing, Michael Wong, Charles F Zorumski, Steven Mennerick

2020-Current year OA Pubs

Neurosteroids that positively modulate GABA

Antidepressant Effect Of Ketamine On Inflammation-Mediated Cytokine Dysregulation In Adults With Treatment-Resistant Depression: Rapid Systematic Review, Shiryn D. Sukhram, Grozdena Yilmaz, Jianying Gu

Publications and Research

Background. Major depressive disorder (MDD) and treatment-resistant depression (TRD) represent a global source of societal and health burden. To advise proper management of inflammation-related depression among TRD patients, it is important to identify therapeutic clinical treatments. A key factor is related to proinflammatory cytokines such as interleukin- (IL-) 1β, IL-6, and tumor necrosis factor- (TNF-) α which have been implicated in the pathogenesis of depressive symptoms in MDD patients. Ketamine may provide an anti-inflammatory therapeutic strategy by targeting proinflammatory pathways associated with depressive disorders, which may be exacerbated in the ageing population with TRD.

Objective. Despite a burgeoning body of …

Ketamine For Acute Pain After Trauma: The Kapt Randomized Controlled Trial, Thaddeus J Puzio, James Klugh, Michael W Wandling, Charles Green, Julius Balogh, Samuel J Prater, Christopher T Stephens, Paulina B Sergot, Charles E Wade, Lillian S Kao, John A Harvin

Journal Articles

BACKGROUND: Evidence for effective pain management and opioid minimization of intravenous ketamine in elective surgery has been extrapolated to acutely injured patients, despite limited supporting evidence in this population. This trial seeks to determine the effectiveness of the addition of sub-dissociative ketamine to a pill-based, opioid-minimizing multi-modal pain regimen (MMPR) for post traumatic pain.

METHODS: This is a single-center, parallel-group, randomized, controlled comparative effectiveness trial comparing a MMPR to a MMPR plus a sub-dissociative ketamine infusion. All trauma patients 16 years and older admitted following a trauma which require intermediate (IMU) or intensive care unit (ICU) level of care are …

Ketamine For Acute Pain After Trauma: The Kapt Randomized Controlled Trial, Thaddeus J Puzio, James Klugh, Michael W Wandling, Charles Green, Julius Balogh, Samuel J Prater, Christopher T Stephens, Paulina B Sergot, Charles E Wade, Lillian S Kao, John A Harvin

Journal Articles

BACKGROUND: Evidence for effective pain management and opioid minimization of intravenous ketamine in elective surgery has been extrapolated to acutely injured patients, despite limited supporting evidence in this population. This trial seeks to determine the effectiveness of the addition of sub-dissociative ketamine to a pill-based, opioid-minimizing multi-modal pain regimen (MMPR) for post traumatic pain.

METHODS: This is a single-center, parallel-group, randomized, controlled comparative effectiveness trial comparing a MMPR to a MMPR plus a sub-dissociative ketamine infusion. All trauma patients 16 years and older admitted following a trauma which require intermediate (IMU) or intensive care unit (ICU) level of care are …

Effectiveness Of Perioperative Ketamine Vs. Opioid Analgesia On Extubation Time And Total Perioperative Opioid Requirement, Robert H. Gray Srna, Sarah S. Hardesty Srna, Heidi E. Higginbotham Srna, Charles A. Hoyt Ii, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Opioid analgesics are a primary source of pain control in the perioperative patient. However, all opioids decrease ventilatory drive secondary to mu2 receptor agonism in the brainstem. Ventilatory depression delays extubation after mechanical ventilation in post-operative patients, thus increasing the risk of complications such as ventilator-associated pneumonia and barotrauma. Non-opioid analgesics such as ketamine have been considered for use in order to reduce this risk. Ketamine is a noncompetitive N-methyl-D-aspartate receptor-antagonizing sedative that bears analgesic properties while preserving respiratory drive. Research suggests that ketamine provides effective perioperative pain control and decreases postoperative extubation time when given alone or with …

The Possible Application Of Ketamine In The Treatment Of Depression In Alzheimer's Disease, Islam Mohammad Shehata, Waniyah Masood, Nouran Nemr, Alexandra Anderson, Kamal Bhusal, Amber N. Edinoff, Elyse M. Cornett, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

Depression is a leading cause of disability globally, with a prevalence of 3.8% among the whole population, 5% of the adult population, and 5.7% of the elderly population over 60 years of age. There is evidence that depression is linked to certain neurodegenerative diseases, one being Alzheimer's disease (AD). The efficacy of conventional antidepressants to treat depression in AD is conflicting, especially regarding selective serotonin reuptake inhibitors (SSRIs). A recent systemic review and meta-analysis of 25 randomized controlled trials including fourteen antidepressant medications showed no high efficacy in treating AD patients' symptoms. However, ketamine, a nonselective N-methyl-D-aspartate (NMDA) receptor antagonist, …

Historical Pathways For Opioid Addiction, Withdrawal With Traditional And Alternative Treatment Options With Ketamine, Cannabinoids, And Noribogaine: A Narrative Review, Amber N. Edinoff, Natalie W. Wu, Catherine A. Nix, Bryce Bonin, Rama Mouhaffel, Stephen Vining, William Gibson, Elyse M. Cornett, Kevin S. Murnane, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

Even as prescription opioid dispensing rates have begun to decrease, the use of illicit opioids such as heroin and fentanyl has increased. Thus, the end of the opioid epidemic is not in sight, and treating patients that are addicted to opioids remains of utmost importance. Currently, the primary pharmacotherapies used to treat opioid addiction over the long term are the opioid antagonist naltrexone, the partial-agonist buprenorphine, and the full agonist methadone. Naloxone is an antagonist used to rapidly reverse opioid overdose. While these treatments are well-established and used regularly, the gravity of the opioid epidemic necessitates that all possible avenues …

Protocol For The Ketamine For Postoperative Avoidance Of Depressive Symptoms (K-Pass) Feasibility Study: A Randomized Clinical Trial, Bradley A Fritz, Bethany R Tellor Pennington, Ben J A Palanca, Julie A Schweiger, Jon T Willie, Nuri B Farber

2020-Current year OA Pubs

No abstract provided.