Depression and Anxiety Disorders

Published: April 10, 2025

Abstract Depression (major depressive disorder) is widely recognised as a major public health problem around the world. The mainstay of treatment prescription antidepressants, although psychological treatments have place first‐line alternative to antidepressants in milder and moderate forms depression. This chapter concentrates on use offers advice drug choice, dosing, switching strategies sequencing treatments. near exclusion other non‐drug modalities does not imply any lack confidence their efficacy but simply reflects need (in prescribing guideline) concentrate medicines‐related subjects. Antidepressants are number anxiety spectrum disorders. Use selective serotonin reuptake inhibitors (SSRIs) preoperative period has been associated with 20% increase inpatient mortality, patient factors rather than could be excluded cause.

Language: Английский

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Ketamine and its two enantiomers in anesthesiology and psychiatry: A historical review and future directions

Journal of Anesthesia and Translational Medicine, Journal Year: 2024, Volume and Issue: 3(3), P. 65 - 75

Published: July 11, 2024

Ketamine, a dissociative anesthetic, is widely utilized in both human and veterinary anesthesia. Its (S)-enantiomer, esketamine, similarly employed for anesthesia analgesia. The anesthetic effects of ketamine esketamine arise from their antagonism the N-methyl-D-aspartate receptor (NMDAR). In field psychiatry, rapid-acting antidepressant properties severe depression have generated significant interest, resulting its increased off-label usage United States (U.S.). 2019, nasal spray received approval use U.S. Europe. However, concerns emerged regarding potential adverse effects, including long-term efficacy, addiction risks, suicide risk clinical settings. contrast, arketamine, (R)-enantiomer ketamine, exhibits superior longer-lasting rodent models depression, with fewer side compared to esketamine. Nevertheless, research on efficacy safety arketamine patients remains limited. This article provides concise exploration historical two enantiomers while also delving into future directions application these fields.

Language: Английский

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Esketamine reduces the risk of postpartum depression in women undergoing cesarean section: a systematic review and meta-analysis

Journal of Psychiatric Research, Journal Year: 2025, Volume and Issue: 183, P. 164 - 173

Published: Feb. 14, 2025

Language: Английский

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Efficacy and safety of peri-partum Esketamine for prevention of post-partum depression in women undergoing caesarian section: A Meta-Analysis and Systematic Review of Randomized Controlled Trials

Asian Journal of Psychiatry, Journal Year: 2024, Volume and Issue: 97, P. 104090 - 104090

Published: May 21, 2024

Language: Английский

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Efficacy and safety of ketamine and esketamine in reducing the incidence of postpartum depression: an updated systematic review and meta-analysis

BMC Pregnancy and Childbirth, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 6, 2025

Abstract Background Postpartum depression (PPD) is categorized by the Disorders-Fifth Edition as that begins during pregnancy or within first month after giving birth. Ketamine and esketamine have shown promising results in treatment of several depressive disorders, which suggests they may a role prevention PPD. This systematic review meta-analysis aim to update evidence about efficacy safety using ketamine reduce PPD incidence. Methods We searched four databases, PubMed, Scopus, Web Science, Cochrane, collect relevant studies. included studies investigated preventive effect on among women birth through caesarean vaginal delivery. extracted occurrence rate, score, pain score side effects. Finally, was conducted RevMan software. Results Twenty-one eligible were incorporated current involving 4,389 pregnant women. Esketamine intervention 14 studies, used 7 In subgroup analysis, both significantly effective reducing incidence short-term (ketamine: RR = 0.72, 95% CI [0.56, 0.93], P 0.01; esketamine: 0.43, < 0.0001). only reduced long-term (RR 0.44, 0.00001). Low doses high (high dose: 0.48, 0.0005; low 0.46, 0.002) 0.54, 0.0001; 0.61, 0.009). Regarding risk effects, patients Ketamine/esketamine group showed statistically significant higher rates developing dizziness ( 0.0007), blurred vision 0.02), vomiting 0.004) hallucinations 0,002) than control group. Conclusion Both are lowering On other hand, It recommended use smaller for more tolerable period since less 0.5 mg effective. Temporary effects such dizziness, vision, reported.

Language: Английский

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Intraoperative Esketamine and Postpartum Depression Among Women With Cesarean Delivery

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(2), P. e2459331 - e2459331

Published: Feb. 13, 2025

Importance Esketamine has been found to reduce the incidence of postpartum depression (PPD) in randomized clinical trials. However, current evidence from trials does not reflect esketamine’s efficacy settings. Objective To assess intraoperative esketamine administration for preventing PPD among women who underwent cesarean delivery. Design, Setting, and Participants This trial was conducted at The First Affiliated Hospital Chongqing Medical University Chongqing, China, March 2023 February 2024. Pregnant patients admitted delivery were included, while those with intellectual dysfunction or contraindications excluded. All participants assigned randomly either group control a 1:1 ratio. Data analysis based on intention-to-treat principle. Interventions Patients received an infusion 0.25 mg/kg 20 mL saline over minutes, whereas minutes. Main Outcomes Measures primary outcome 6 weeks post partum. assessed using Edinburgh Postnatal Depression Scale. Results A total 308 pregnant 1 2 groups: (n = 154; mean [SD] patient age, 31.57 [4.26] years) 32.53 [7.74] years). Incidence significantly lower compared partum (10.4% [16] vs 19.5% [30]; relative risk, 0.53; 95% CI, 0.30-0.93; P .02). Conclusions Relevance demonstrated advantage reducing safety warrant further investigation practice. Trial Registration Chinese Clinical Registry Identifier: ChiCTR2200065494

Language: Английский

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Impact of esketamine intravenous analgesic pump on pain and depression post-cesarean

BMC Surgery, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 8, 2025

Postoperative pain and psychological well-being in postpartum women following cesarean section are critical for optimal maternal recovery. Traditional analgesics often have limitations side effects, prompting the need alternative solutions. This study evaluates impact of an esketamine intravenous analgesic pump on postoperative status section. A comprehensive retrospective evaluation was conducted at our institution from October 2021 to July 2023, including 168 patients who underwent delivery. The observation group (n = 82) received via pump, while control 86) traditional therapy. Data collected included demographic information, surgical details, (assessed using Visual Analog Scale, VAS), Edinburgh Postnatal Depression EPDS), recovery metrics, adverse reactions. demonstrated consistently lower VAS scores all time points compared group, indicating superior control. EPDS were significantly 3, 5, 14 days postoperatively, suggesting better outcomes. incidence depression also days. Recovery metrics such as first ambulation, flatus, initiation lactation improved group. There no significant differences reactions between groups. use Esketamine Intravenous Analgesic Pump reduces within It promotes early breastfeeding without reactions, making it a valuable addition care.

Language: Английский

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Ascorbic Acid and Esketamine for Mental Disorders in Women with Miscarriage: A Randomized Controlled Double-Blind Trial Protocol

Neuropsychiatric Disease and Treatment, Journal Year: 2025, Volume and Issue: Volume 21, P. 815 - 825

Published: April 1, 2025

Pregnancy leads to vulnerabilities and susceptibilities mental disorders. Miscarriage, as an adverse pregnancy outcome, following curettage for treatment, add the risks of further psychiatric disorders, including depression, anxiety, insomnia, etc., current approaches prevention are unsatisfactory. Ketamine its S-enantiomer esketamine can prevent postpartum even treats depressive symptoms after miscarriage curettage, but their side effects bring limitations. Ascorbic acid (AA, Vitamin C) modulate mood enhance ketamine's antidepressant efficacy synergistically, reducing dosages potentially. The purpose this study is clarify beneficial modification AA on preventing depression other disorders in patients with painless well interaction between esketamine. This a 2×2 factorial, double-blinded, randomized, controlled trial that will recruit women undergoing curettage. A total 424 participants be recruited randomly 1:1:1:1 allocated four groups (106 each): Group A0K0 (normal saline normal saline), A0K1 esketamine), A1K0 (AA A1K1 esketamine). primary outcome incidence postoperative day 7, assessed Edinburgh Postnatal Depression Scale (EPDS). secondary outcomes include EPDS score, assessments sleep, pain, events, perianesthetic data patient satisfaction. provides clinical trial-based evidence alone or combination/interacting emerging rapid-acting Our expected suggest AA's potential application optimizing strategies promoting post-miscarriage health, possible adjunctive improvement (es)ketamine's usage antidepressants. One major limitation single-center study, results might biased due regional factors.

Language: Английский

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Ketamine and Perinatal Mental Health: Problems and Potentials

The Canadian Journal of Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: April 13, 2025

Language: Английский

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Efficacy of esketamine for perinatal depression: a systematic review and meta-analysis

CNS Spectrums, Journal Year: 2024, Volume and Issue: 29(5), P. 326 - 334

Published: Oct. 1, 2024

Abstract Objective Postpartum depression (PPD), now referred to as perinatal depression, is a prevalent and debilitating mood disorder that reduces health-related quality of life (HRQoL) psychosocial functioning. Esketamine, which efficacious in adults with treatment-resistant individuals suicidality, also analgesic pain management during childbirth labour. Herein, we investigate the efficacy prophylactic esketamine reducing incidence PPD. Methods We performed systematic review (i.e., PubMed, Scopus, Ovid databases; inception January 22, 2024) randomized controlled trials investigated use for delimited our search studies prespecified prevention PPD primary outcome. A meta-analysis was on rates using random effects model. Results Our analysis consisted seven met eligibility criteria. found significantly associated decreased diagnosis within one week (OR = 0.30, 95% CI [0.15, 0.60], p 0.0047). observed between 4 6 weeks post-delivery 0.33, [0.18, 0.59], 0.0034). Conclusion results indicate may have preventive antidepressant postpartum period. The aforementioned points both mechanistic clinically meaningful implications treatment

Language: Английский

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