The Evidence for Ketamine in Mood Disorders: February 2020
AKH Inc., Advancing Knowledge in Healthcare and Psychiatric Annals
Table of Contents
Neurobiological Mechanisms of Ketamine: Depression, Suicide, Trauma, and Chronic Stress Pathologies
Lynnette A. Averill, PhD; Christopher L. Averill, MS; Chadi G. Abdallah, MD
Ketamine, Esketamine, and A New Generation of Antidepressants
Samuel T. Wilkinson, MD; Brandon M. Kitay, MD, PhD
Comparative Efficacy of Ketamine in Treatment-Resistant Depression
Hatice Guncu Kurt, MD; Murat Altinay, MD; Amit Anand, MD
Development of Ketamine Administration as a Treatment for Chronic PTSD
Abigail B. Collins, BS; Sarah B. Rutter, MA; Adriana Feder, MD
Sponsorship Statement: This CME activity is jointly sponsored by AKH Inc., Advancing Knowledge in Healthcare and Psychiatric Annals.
Support Statement: There is no commercial support for this activity.
- Identify the strengths and limitations of ketamine treatment as a rapid-acting antidepressant.
- Recognize the current state of evidence for ketamine use as an off-label treatment for mood disorders.
- Discuss treatment options for treatment-resistant depression and the efficacy of each modality.
- Recognize ketamine administration as a potential treatment for chronic posttraumatic stress disorder.
Author names and affiliations: See authors above
Guest Editor: Sanjay J. Mathew, MD
Reviewer names: Andrew A. Nierenberg, MD, Editor, and Lenard A. Adler, MD, CME Coordinator, Psychiatric Annals
Disclosure statement: In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue and also on this page.
Faculty members report the following financial relationships: Andrew A. Nierenberg, MD, has disclosed the following relevant financial relationships: Appliance Computing Inc. (Mindsite); Astra Zeneca; Brain Cells, Inc.; Brandeis University; Bristol Myers Squibb; Clintara, Dianippon Sumitomo/Sepracor; Eli Lilly and Company; EpiQ, Forest; Johnson and Johnson; Labopharm; Merck; Methylation Science; Novartis; PamLabs; PGx Health; Shire; Schering-Plough; Sunovion; Takeda/Lundbeck Pharmaceuticals; Targacept; Teva: Consultant. APSARD; Belvoir Publishing; Boston Center for the Arts; University of Texas Southwestern Dallas; Hillside Hospital; American Drug Utilization Review; American Society for Clinical Psychopharmacology; Bayamon Region Psychiatric Society; Baystate Medical Center; Canadian Psychiatric Association; Columbia University; Douglas Hospital/McGill University; IMEDEX; International Society for Bipolar Disorders; Israel Society for Biological Psychiatry; John Hopkins University; MJ Consulting; Massachusetts Association of College Counselors; Medscape; MBL Publishing; Physicians Postgraduate Press; Ryan Licht Sang Foundation; Slack Publishing; SUNY Buffalo; University of Florida; University of Miami; University of Wisconsin; University of Pisa; SciMed: Honoraria / travel expenses. Appliance Computing, Inc.; Brain Cells, Inc.: Stock options. AHRQ; Cephalon; Forest; Mylan; NIMH; PamLabs; Pfizer Pharmaceuticals; Takeda; Elan; Shire: Grant / research support.
Lenard A. Adler has disclosed the following relevant financial relationships: research grants paid to New York University (NYU) on Dr. Adler’s behalf from Sunovion Pharmaceuticals, Shire Pharmaceuticals, Lundbeck, Enzymotec, Purdue Pharma; personal fees for consulting or advisory boards from Sunovion Pharmaceuticals, Enzymotec, Shire Pharmaceuticals, the National Football League, Major League Baseball, Shire Pharmaceuticals, Otsuka Pharmaceuticals, Alcobra Pharmaceuticals; and royalty fees from NYU School of Medicine for license of Adult ADHD rating scales and training materials.
Authors report the following financial relationships: Sanjay J. Mathew has served as a consultant for Allergan, Alkermes, Clexio, Intra-Cellular Therapies, Janssen, and Perception Neurosciences; and discloses contracted research with Biohaven Pharmaceuticals and VistaGen Therapeutics. Lynnette A. Averill has no relevant financial relationships to disclose. Christopher L. Averill has no relevant financial relationships to disclose. Chadi G. Abdallah has served as a consultant, speaker, and/or a member of the advisory boards for Genentech, Janssen, Lundbeck, and FSV7; and is the Editor of the journal Chronic Stress for Sage Publications, Inc. Samuel T. Wilkinson has received contract funding from Janssen(the developer of esketamine) and Sage Therapeutics for the conduct of clinical trials administered through Yale University; anticipates receiving contract funding from LivaNova for conducting clinical trials; and has received consulting fees from Janssen, Oui Therapeutics, and Biohaven Pharmaceuticals. Brandon M. Kitay has received contract funding from Janssen and Sage Therapeutics for the conduct of clinical trials administered through Yale University. Hatice Guncu Kurt has no relevant financial relationships to disclose. Murat Altinay has no relevant financial relationships to disclose. Amit Anand has no relevant financial relationships to disclose. Abigail B. Collins has no relevant financial relationships to disclose. Sarah B. Rutter has no relevant financial relationships to disclose. Adriana Feder is a named co-inventor on a patent application in the United States, and on several issued patents outside the US, filed by the Icahn School of Medicine at Mount Sinai related to the use of ketamine for the treatment of posttraumatic stress disorder. This intellectual property has not been licensed.
Accreditation statement(s): This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and SLACK Incorporated. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.
Credit designation: AKH Inc., Advancing Knowledge in Healthcare designates this enduring material for a maximum of 3.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Release date: February 1, 2020. Expiration Date: March 1, 2023.
How to participate: To participate in this CME activity, you must read the learning objectives, read the articles, complete the CME posttest, and complete the evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 70% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, AKH Inc., Advancing Knowledge in Healthcare will issue an AMA PRA Category 1 Credit(s)™ certificate.
Target audience: This CME activity is primarily targeted to patient-caring psychiatrists, physicians specializing in psychiatry, and others allied to the field. There are no specific background requirements for participants taking this activity.
Unlabeled and investigational usage statement: The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The authors have been made aware of their obligation to disclose such usage.