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Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder
Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketami...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5923813/ https://www.ncbi.nlm.nih.gov/pubmed/29673146 http://dx.doi.org/10.3390/ijerph15040771 |
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author | Rong, Carola Park, Caroline Rosenblat, Joshua D. Subramaniapillai, Mehala Zuckerman, Hannah Fus, Dominika Lee, Yena L. Pan, Zihang Brietzke, Elisa Mansur, Rodrigo B. Cha, Danielle S. Lui, Leanna M. W. McIntyre, Roger S. |
author_facet | Rong, Carola Park, Caroline Rosenblat, Joshua D. Subramaniapillai, Mehala Zuckerman, Hannah Fus, Dominika Lee, Yena L. Pan, Zihang Brietzke, Elisa Mansur, Rodrigo B. Cha, Danielle S. Lui, Leanna M. W. McIntyre, Roger S. |
author_sort | Rong, Carola |
collection | PubMed |
description | Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. Method: Electronic search engines PubMed/MEDLINE, ClinicalTrials.gov, and Scopus were searched for relevant articles from inception to January 2018. The search term ketamine was cross-referenced with the terms depression, major depressive disorder, bipolar disorder, predictors, and response and/or remission. Results: Multiple baseline pretreatment predictors of response were identified, including clinical (i.e., Body Mass Index (BMI), history of suicide, family history of alcohol use disorder), peripheral biochemistry (i.e., adiponectin levels, vitamin B12 levels), polysomnography (abnormalities in delta sleep ratio), neurochemistry (i.e., glutamine/glutamate ratio), neuroimaging (i.e., anterior cingulate cortex activity), genetic variation (i.e., Val66Met BDNF allele), and cognitive functioning (i.e., processing speed). High BMI and a positive family history of alcohol use disorder were the most replicated predictors. Conclusions: A pheno-biotype of depression more, or less likely, to benefit with ketamine treatment is far from complete. Notwithstanding, metabolic-inflammatory alterations are emerging as possible pretreatment response predictors of depressive symptom improvement, most notably being cognitive impairment. Sophisticated data-driven computational methods that are iterative and agnostic are more likely to provide actionable baseline pretreatment predictive information. |
format | Online Article Text |
id | pubmed-5923813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-59238132018-05-03 Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder Rong, Carola Park, Caroline Rosenblat, Joshua D. Subramaniapillai, Mehala Zuckerman, Hannah Fus, Dominika Lee, Yena L. Pan, Zihang Brietzke, Elisa Mansur, Rodrigo B. Cha, Danielle S. Lui, Leanna M. W. McIntyre, Roger S. Int J Environ Res Public Health Article Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. Method: Electronic search engines PubMed/MEDLINE, ClinicalTrials.gov, and Scopus were searched for relevant articles from inception to January 2018. The search term ketamine was cross-referenced with the terms depression, major depressive disorder, bipolar disorder, predictors, and response and/or remission. Results: Multiple baseline pretreatment predictors of response were identified, including clinical (i.e., Body Mass Index (BMI), history of suicide, family history of alcohol use disorder), peripheral biochemistry (i.e., adiponectin levels, vitamin B12 levels), polysomnography (abnormalities in delta sleep ratio), neurochemistry (i.e., glutamine/glutamate ratio), neuroimaging (i.e., anterior cingulate cortex activity), genetic variation (i.e., Val66Met BDNF allele), and cognitive functioning (i.e., processing speed). High BMI and a positive family history of alcohol use disorder were the most replicated predictors. Conclusions: A pheno-biotype of depression more, or less likely, to benefit with ketamine treatment is far from complete. Notwithstanding, metabolic-inflammatory alterations are emerging as possible pretreatment response predictors of depressive symptom improvement, most notably being cognitive impairment. Sophisticated data-driven computational methods that are iterative and agnostic are more likely to provide actionable baseline pretreatment predictive information. MDPI 2018-04-17 2018-04 /pmc/articles/PMC5923813/ /pubmed/29673146 http://dx.doi.org/10.3390/ijerph15040771 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rong, Carola Park, Caroline Rosenblat, Joshua D. Subramaniapillai, Mehala Zuckerman, Hannah Fus, Dominika Lee, Yena L. Pan, Zihang Brietzke, Elisa Mansur, Rodrigo B. Cha, Danielle S. Lui, Leanna M. W. McIntyre, Roger S. Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title | Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title_full | Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title_fullStr | Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title_full_unstemmed | Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title_short | Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder |
title_sort | predictors of response to ketamine in treatment resistant major depressive disorder and bipolar disorder |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5923813/ https://www.ncbi.nlm.nih.gov/pubmed/29673146 http://dx.doi.org/10.3390/ijerph15040771 |
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