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Ketamine and esketamine for crisis management in patients with depression: Why, whom, and how? by Aiste Lengvenyte; Robertas Strumila; Emilie Olié; Philippe Courtet is a Medicine article available to read on EtoBox.

What is Ketamine and esketamine for crisis management in patients with depression: Why, whom, and how? about?

Currently, only a limited number of interventions can rapidly relieve depressive symptomatology in patients with major depressive disorder or bipolar disorder experiencing extreme distress. Such crises, especially when suicide attempt or ideation is involved, are a major risk factor of suicide. Ketamine, a N-methyl-d-aspartate glutamate receptor antagonist, and its enantiomer esketamine rapidly reduce depressive symptoms in depressed patients with current suicidal ideation. Recently, esketamine has been approved for use in patients with depression at risk of suicide and for psychiatric emergency by major medical agencies in the United States and Europe, whereas ketamine is increasingly used off-label. However, there is currently limited guidance on why, when, and how to use these drugs in patients with depression to treat a crisis. In this review article, we provide a succinct overview of the cellular and molecular mechanisms of action of ketamine and esketamine, and of the functional brain changes following their administration. We also summarize the major clinical studies on ketamine and esketamine efficacy in patients experiencing a crisis (generally, suicidal ideation), and pro

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Author

Aiste Lengvenyte; Robertas Strumila; Emilie Olié; Philippe Courtet

Publisher

Elsevier BV

Published

2022

Language

EN

Field

Medicine (Life Sciences)