![Ketamine for Treatment-Resistant Depression](https://img.perlego.com/book-covers/1897223/9780128210345_300_450.webp)
eBook - ePub
Ketamine for Treatment-Resistant Depression
Neurobiology and Applications
Gustavo H. Vazquez,Carlos A. Zarate,Elisa Brietzke
This is a test
- 168 pages
- English
- ePUB (mobile friendly)
- Available on iOS & Android
eBook - ePub
Ketamine for Treatment-Resistant Depression
Neurobiology and Applications
Gustavo H. Vazquez,Carlos A. Zarate,Elisa Brietzke
Book details
Book preview
Table of contents
Citations
About This Book
Ketamine for Treatment-Resistant Depression: Neurobiology and Applications provides a simple, evidence-based overview for neuropsychiatrists and translational researchers on this medication, its mechanisms of actions, eligibility of patients for treatment, and the preparation and implementation of ketamine clinics.
- Provides efficacy research on ketamine as a treatment for depression
- Identifies best practices for clinical use, both long-term and acute
- Discusses the molecular mechanisms and neurobiology of action
Frequently asked questions
How do I cancel my subscription?
Can/how do I download books?
At the moment all of our mobile-responsive ePub books are available to download via the app. Most of our PDFs are also available to download and we're working on making the final remaining ones downloadable now. Learn more here.
What is the difference between the pricing plans?
Both plans give you full access to the library and all of Perlegoâs features. The only differences are the price and subscription period: With the annual plan youâll save around 30% compared to 12 months on the monthly plan.
What is Perlego?
We are an online textbook subscription service, where you can get access to an entire online library for less than the price of a single book per month. With over 1 million books across 1000+ topics, weâve got you covered! Learn more here.
Do you support text-to-speech?
Look out for the read-aloud symbol on your next book to see if you can listen to it. The read-aloud tool reads text aloud for you, highlighting the text as it is being read. You can pause it, speed it up and slow it down. Learn more here.
Is Ketamine for Treatment-Resistant Depression an online PDF/ePUB?
Yes, you can access Ketamine for Treatment-Resistant Depression by Gustavo H. Vazquez,Carlos A. Zarate,Elisa Brietzke in PDF and/or ePUB format, as well as other popular books in Biological Sciences & Neuroscience. We have over one million books available in our catalogue for you to explore.
Information
Chapter 1: Ketamine, Clio, and the hippocratic triangleâfragments of the history of ketamine
Casimiro Cabrera-Abreu, LMS, MSc, MRCPsych, FRCPC 1 , 2 , and Mariel Cabrera-Mendez, MD 3 1 Associate Professor, Psychiatry, Queenâs University, Kingston, ON, Canada 2 Attending Psychiatrist, Mood Disorders Research and Treatment Service, Providence Care Hospital, Kingston, ON, Canada 3 Research Assistant, Providence Care Hospital, Kingston, ON, Canada
abstract
The objective of this chapter is to highlight some intriguing aspects of the history of ketamine. First, we will review the methodologies used when writing a small fragment of the overall history of psychopharmacology. Second, and due to the recent explosion of papers on ketamine and related substances in the past decade, we have focused on two themes, the interplay of ketamine with the nosologic status of âdissociationâ and the repeated encounters of Edward Domino with ketamine and some of its psychotropic effects. Finally, this chapter does not end offering some inchoate conclusions or pretentious sagely advice about the future of psychopharmacology and the glutamate antagonists but rather wishes to be a critical reflection on psychiatry's constant reinvention and shifting paradigms, as it has been fashionable to say since Kuhn.
Keywords
Dissociation; Dissociative anesthesia; Dizocilpine; History; Ketamine; Phencyclidine
Introduction
In 2003, Edward Shorter and Peter Tyrer, a historian of psychiatry and one of the associate editors at the time of the British Journal of Psychiatry, respectively, published an intriguing paper about the nature of âcothymiaâ and the accompanying drought in the discovery of new antidepressants. 1 Their paper was boldly published during a period when the hegemony of the Diagnastic and Statistical Manual of Mental Disorders (DSM) classification system was undisputed and absolute; nobody who wished to publish in an August psychiatric journal dared not to use DSM. Tyrer, with his characteristic dry wit, touched upon this issue in a later paper with a similar subject. 2 By the beginning of the next decade, Stephen E. Hyman 3 deplored the announcement of a number of pharmaceutical companies concerning the closure of several lines of investigation in the field of psychotropic medications; the stagnation in the production of novel antidepressants became alarming. It is therefore remarkable that in a time when the future of the psychopharmacology of depression appeared to be barren, a ârevivalâ of an âoldâ substance from the field of anesthesia appeared to ârevolutionizeâ the treatment of depression. 4 Ketamine was introduced in anesthesia about the time the first âantidepressantsâ were launched (the 1950 and 1960s) but had to wait 50 years to become the new enfant terrible of psychopharmacology.
In a recent paper, John Krystal and his collaborators, 4 incorporating the ârevolutionaryâ halo carried by ketamine, hailed the introduction of ketamine for depression as a proverbial âparadigm shift,â ĂĄ la Kuhn, 5 in psychopharmacology, comparable to the âPsychopharmacological Revolutionâ of the aforementioned 1950 and 1960s. This chapter covering the (admittedly fragmented and partial) history of ketamine unravels thus in the context of the triumphalist assumptions of the turn-of-the-century diagnostic psychiatry 6 culminating in the recent controversies (debacle?) of DSM-5. 7 The issue of the sociohistorical context is apposite and with ironic justice brings to mind the image of the âset and settingâ of Hartogsohn. 8
The purpose of this chapter is to follow the tribulations of ketamine and some of its psychotropic effects and how they have been interpreted in the context of the changing nosologic and nosographical vicissitudes of North American psychiatry during the past 5 decades. Without doubt, Edward Domino has been an important figure throughout this period; some of his encounters with ketamine and its congeners will also be briefly reviewed.
A note on methodology
The issue of context highlighted earlierâwhere and when does this narrative take placeâleads us to the problem of the historiographical (i.e., the methodology) tools used in this chapter. This is important because there appears to be a small cottage industry rapidly building up around the history of ketamine. 9â12 Although essential reading, it is difficult not to think of Ben Shephard's 13 comments when describing the âfunctional approach to historyâ of busy psychiatrists [and academic researchers] at the time of writing the history of posttraumatic stress disorder, which according to him is comparable to that of the Communist Party in The Brezhnev epoch, âThe medical literature of the past is important and interesting when it buttresses and legitimizes present practice. When it doesn't, forget itâ. 13 Be as it may, the historical snapshots offered in this chapter supplement the contributions of those authors.
Since Kuhn's weaponization of Butterfield's concept of âwhiggishnessâ as a fundamental principle in the history of science, 14 a âpresentist, internalist, or hagiographicâ approach/methodology has been declared deficient or suboptimal 15 at the time of pursuing historical endeavors. This creates significant problems for the two authors, a clinical psychiatrist and an MD, none of whom have professional training in the methods of âHistoryâ (with a capital H), who attempt to operate within the current fashion of the rigorous bounds imposed by the âevidence-basedâ study of facts. The temptation of writing a history with a âking and battle bent,â as Edwin Wallace IV once said 16 or ĂĄ la Brezhnev, in the words of Ben Shephard, is considerable. One of the approaches followed in this chapter is inspired by the âHippocratic triangleâ posited by Jacalyn Duffin 17 that includes the âclinician-historianâ and its study of history as an inherently flexible task or a set of tasks in which regular calibration and recalibration, from several sources, should be explicitly stated (which is also redolent of the methodology of Berrios). Needless to say, other subtle influences are at work when writing these lines. We can only hope that they will become more or less visible as the text unravels; that is, the intended purpose is that these âmethodologiesâ and influences will become evident when addressing different aspects of the history of ketamine.
Continuing with the issue of the techniques used to offer a glimpse of the history of ketamine and its use in patients with mental illness, it is de rigueur to return to Berrios. 15 , 18 In studying the history of mental illnesses, Berrios suggests specifying if we are tracking the history of some of (1) the terms (in this chapter, âdissociationâ is an essential term that drives the narrative) or the historical meanderings of (2) the concepts attached to those terms or, finally, (3) the behaviors of the patients.
The task of writing a history of ketamine and its use in mental illness becomes particularly complex when the nosology and nosography of mental illnesses is also in flux, and this is illustrated, for example, by the choice of terminology for the action of ketamine as an anesthetic; I am referring to the term âdissociative anesthesia.â Paraphrasing Farrell 19 trying to write this history against a changing psychiatric culture â[ âŚ] is akin to measuring a developing weather front with a stepladder and a yardstick.â
One of the most interesting aspects of the introduction of ketamine to treat depression (and acute suicidal ideation) is the potential implications that the polymorphic nature of the altered âstates of consciousnessâ induced by this substance can bring not only to the terrain of the pathophysiology of depression but also to our current understanding of the pathogenesis of other disorders.
The origin of the term dissociative anesthesia
The story of how the wave of psychotomimetic effects caused by ketamine and its study leads to the term âdissociative anesthesiaâ has been covered several times; however, and for the purposes of this chapter, it deserves some attention. In an often-quoted paper titled Taming the Ketamine Tiger, Edward Domino 20 described how he was asked to work with the forerunner of ketamine, phencyclidine (PCP), by his mentor, Dr. Maurice Seevers, 21 who was the Head of Pharmacology at the University of Michigan. Domino then recollects his discovery that PCP could produce âemergency deliriumâ in dogs and how PCP acted as a...
Table of contents
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Chapter 1. Ketamine, Clio, and the hippocratic triangleâfragments of the history of ketamine
- Chapter 2. Ketamine's potential mechanism of action for rapid antidepressive effects â a focus on neuroplasticity
- Chapter 3. Treatment resistant depression
- Chapter 4. Suicide in psychiatric disorders: rates, risk factors, and therapeutics
- Chapter 5. Overview of ketamine for major depression: efficacy and effectiveness
- Chapter 6. How to implement a ketamine clinic
- Chapter 7. Development of new rapid-action treatments in mood disorders
- Chapter 8. Closing remarks
- Index
Citation styles for Ketamine for Treatment-Resistant Depression
APA 6 Citation
[author missing]. (2020). Ketamine for Treatment-Resistant Depression ([edition unavailable]). Elsevier Science. Retrieved from https://www.perlego.com/book/1897223/ketamine-for-treatmentresistant-depression-neurobiology-and-applications-pdf (Original work published 2020)
Chicago Citation
[author missing]. (2020) 2020. Ketamine for Treatment-Resistant Depression. [Edition unavailable]. Elsevier Science. https://www.perlego.com/book/1897223/ketamine-for-treatmentresistant-depression-neurobiology-and-applications-pdf.
Harvard Citation
[author missing] (2020) Ketamine for Treatment-Resistant Depression. [edition unavailable]. Elsevier Science. Available at: https://www.perlego.com/book/1897223/ketamine-for-treatmentresistant-depression-neurobiology-and-applications-pdf (Accessed: 15 October 2022).
MLA 7 Citation
[author missing]. Ketamine for Treatment-Resistant Depression. [edition unavailable]. Elsevier Science, 2020. Web. 15 Oct. 2022.