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  • Ketamine: 50 Years of Modulating the Mind

    Ketamine: 50 Years of Modulating the Mind

    Abstract

    Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine’s effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal (“top down”) distribution. This proposed mechanism of general anesthesia has since been demonstrated with anesthetics in other pharmacological classes as well. Ketamine remains invaluable to the fields of anesthesiology and critical care medicine, in large part due to its ability to maintain cardiorespiratory stability while providing effective sedation and analgesia. Furthermore, there may be an emerging role for ketamine in treatment of refractory depression and Post-Traumatic Stress Disorder. In this article, we review the history of ketamine, its pharmacology, putative mechanisms of action and current clinical applications.

    [button url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126726/”]Read the Full Article Here[/button]

  • Ketamine Administration in Depressive Disorders: A Systematic Review and Meta-Analysis.

    Ketamine Administration in Depressive Disorders: A Systematic Review and Meta-Analysis.

    INTRODUCTION:

    Ketamine’s efficacy in depressive disorders has been established in several controlled trials. The aim of the present study was to determine whether or not ketamine administration significantly improves depressive symptomatology in depression and more specifically in major depressive disorder (MDD), bipolar depression, resistant depression (non-ECT studies), and as an anesthetic agent in electroconvulsive therapy (ECT) for resistant depression (ECT studies). Secondary outcomes were the duration of ketamine’s effect, the efficacy on suicidal ideations, the existence of a dose effect, and the safety/tolerance of the treatment.

    [button url=”https://www.ncbi.nlm.nih.gov/pubmed/25038867″]Read the Full Article Here[/button]

  • Should Anesthesiologists Administer Ketamine – SoCal PBS Interview Part 2

    Should Anesthesiologists Administer Ketamine – SoCal PBS Interview Part 2

    Excerpts of PBS SoCal show on the drug ketamine for the treatment of depression.

     

  • New Mechanisms Elicited with Ketamine in Treatment-Resistant Depression

    New Mechanisms Elicited with Ketamine in Treatment-Resistant Depression

    Ronald S. Duman, PhD, Elizabeth Mears, Ph.D., and House Jameson, Ph.D., Professor of Psychiatry and Professor of Neurobiology and of Pharmacology at Yale School of Medicine, discuss advances in the treatment of depression. (April 2011)

  • Ketamine Acts as Antidepressant by Boosting Serotonin

    Ketamine Acts as Antidepressant by Boosting Serotonin

    Date: January 7, 2014

    Source: RIKEN

    Summary: PET molecular imaging of the brain reveals that ketamine may act as an antidepressant by boosting serotonin activity in brain areas involved in motivation.

    [button url=”https://www.sciencedaily.com/releases/2014/01/140107102442.htm”]Read the Full Story Here[/button]

  • How Depression and Antidepressant Drugs Work

    How Depression and Antidepressant Drugs Work

    Date: May 18, 2016

    Source: Penn State

    Summary: New research demonstrates the effectiveness of ketamine to treat depression in a mouse model of the disease. The brings together two hypotheses: 1) that depression results from deficits in GABA signaling and 2) that depression results from deficits in glutamate signaling. It shows that the depression-like behavior in the research mice results from the reduction of both GABA and glutamate, and importantly, that both can be restored with a single dose of ketamine.

    [button url=”https://www.sciencedaily.com/releases/2016/05/160518165254.htm”]Read Full Article Here[/button]

  • Intravenous Ketamine May Rapidly Reduce Suicidal Thinking in Depressed Patients

    Intravenous Ketamine May Rapidly Reduce Suicidal Thinking in Depressed Patients

    Date: May 10, 2016

    Source: Massachusetts General Hospital

    Summary: Repeat ketamine infusions decreased — and for some, eliminated — suicidal thoughts in outpatients with treatment-resistant depression, report investigators.

    [button url=”https://www.sciencedaily.com/releases/2016/05/160510134545.htm”]Read the Full Article Here[/button]

  • From Drug of Abuse to a Glimpse Into Depression

    From Drug of Abuse to a Glimpse Into Depression

    Date: May 18, 2016

    Source: American Association of Pharmaceutical Scientists (AAPS)

    Summary: Ketamine, a synthetic analogue of PCP, has recently taken the spotlight as a novel, fast-acting antidepressant. However, experts say that more research on usage of ketamine as an antidepressant is needed.

    [button url=”https://www.sciencedaily.com/releases/2016/05/160518153407.htm”]Read Full Article Here[/button]

  • Ketamine Lifts Depression via a Byproduct of its Metabolism

    Ketamine Lifts Depression via a Byproduct of its Metabolism

    Date: May 4, 2016

    Source: NIH/National Institute of Mental Health

    Summary: A chemical byproduct, or metabolite, created as the body breaks down ketamine likely holds the secret to its rapid antidepressant action. This metabolite singularly reversed depression-like behaviors in mice without triggering any of the anesthetic, dissociative, or addictive side effects associated with ketamine. The discovery fundamentally changes scientists’ understanding of how this rapid antidepressant mechanism works and holds promise for improved treatments.

    [button url=”https://www.sciencedaily.com/releases/2016/05/160504141131.htm”]Read Full Article Here[/button]

  • The Science of Happiness: What You Can Do to Achieve It

    The Science of Happiness: What You Can Do to Achieve It

    Photo of family catching snowflakes who have found happiness in their relationshipsThe science of happiness is rather new as a science, but the pursuit of happiness is something we’re all familiar with. Everybody searches for happiness all through life. In fact, it’s ranked right up there with food and water since the days of cave men. As long as man has lived on earth, he’s sought ways to be happy. Even the founding fathers, while framing US democracy, highlighted their core principle as the fundamental human desire for life, liberty, and the pursuit of happiness.

    In recent years, psychologists, neuroscientists, and economists have been exploring the science of happiness.  What is happiness? What causes it? Does something prevent it? Can it be created or is it dependent on circumstances? The science of happiness is a young science, but is helping us learn how to acquire this important element of life for ourselves.

    Researchers who combine their data learn more than ever before about the answers to these questions. For instance, they’ve learned without question that wealth isn’t the source of happiness, any more than health, or fame, or power. But they’ve learned even more than that…

    Science of Happiness researchers also learned there’s a long list of resources that do help us actually cultivate our own happiness, and contribute to it in the lives of others.

    The idea that the fulfillment of our dreams will create happiness has already been discredited through documented studies. Landmark events like winning the lottery, or finishing college, or getting married–which most people think would bring happiness–have been shown to only bring it for a short time… as little as an average of three months!!

    Surprisingly, heartbreaking experiences have a similar impact. People who experience job loss, romantic breakup, death of a loved one, or even blindness suffer the worst of it at first — and within three months are beginning to find reasons for happiness in their new readjusted life. They learn about new things to enjoy in their lives they wouldn’t have known existed without this jarring change.

    In fact, research has established that most people are more resilient than they think they are. They begin looking for the silver linings in life no matter what happens. And they’re surprised to find that they do.

    Whether good or bad, happy or sad, experiences from outside ourselves have a temporary impact…but lasting happiness seems to come from within.

    So, is it possible to create happiness for yourself, or are you limited to waiting for happiness or hoping you’ll feel it or find it?

    The studies conducted by “happiness scientists” and “positive psychologists” have demonstrated that you have within yourself the ability to create your own happiness. To actually “synthesize” it. And the happiness you gain from happy circumstances is only one of the types of happiness available to you.

    You might ask whether the happiness you synthesize even counts, or if it’s a false form of something that must be genuine to be of value. The  collective answer is a resounding NO, it’s not false, but actually very real. If you feel it, it IS real and it’s yours. And knowing how to create it for yourself means that you’re not a slave to circumstances. But you’re definitely independent to enjoy your life your way and overcome whatever difficulties come along.

    So How?? How Can You Make Your Own Happiness?

    The answers may surprise you. Some may seem obvious, like exercise and getting plenty of rest. But others may seem counter-intuitive, like giving away rather than getting what you want. See what you think as you read through the answers below:

    1. Build Relationships

    Build strong and healthy relationships – Relationships  play a huge role in your access to happiness. The ones where you openly and honestly express your heart are the most powerful single element in anyone’s level of happiness. A friend with whom you can share your fears, successes, losses, and hopes and know you’re accepted provides a nourishment nothing else can rival.

    Of course, for that relationship to be fully functional, your friend or partner needs to feel the same safety and support with you. Relationships where you both express genuine interest in each other’s life and concerns, providing encouragement and support, are enriching and create positive feelings…like happiness.

    2. Show Kindness

    Random acts of kindness toward others you know and those you don’t know, bring an overall sense of fulfillment and peace. Volunteering or caring for loved ones consistently brings joy, happiness, and reduces depression.

    3. Get Regular Exercise

    Exercise and physical movement improves emotional well-being and lowers the occurrence of depression.

    The Cochrane Review, that highly prominent medical review with huge influence in the global medical community, published a landmark review and analysis of over 20 studies on the link between exercise and depression. It drew a major conclusion:  exercise has a “large clinical impact” on depression.

    Game-changing discoveries like the gut-brain axis and the link between large sugar consumption and depression also shows the impact of physical well-being and health on emotions.

    4. Embrace Your FlowPhoto of happy, mature woman who enjoys the flow in her life as she pursues her passion and is fulfilled.

    Finding Your “Flow”  comes through being deeply involved in working to reach a certain goal, or engaging in a challenging activity that’s stretching but well-matched to your skills. It’s a joyful state, even exhilarating at times, and creates its own internal motivation that cycles with the rewards and joy it produces.

    5.  Nurture Spiritual Engagement and Deeper Meaning

    Nurturing spiritual engagement and deeper meaning in life was found to be closely connected to happiness. People who are part of a spiritual community and regularly participate in spiritual activities have a higher level of happiness than those who aren’t. Through spiritual development, deeper levels of meaning and fulfillment can be discovered and assimilated.

    6. Develop Your Strengths and Virtues

    Identify, develop, and gain confidence in your strengths and virtues.  An expert in the field of Positive Psychology, Martin Seligman, conducted studies that confirmed that the happiest people are the ones who know their strengths and virtues, and use them to further goals greater than themselves.

    Strengths can be things like persistence, tenacity, and analytical thinking. Virtues can be qualities like compassion, integrity, and tolerance. Using your best traits to help others is a great generator of happiness.

    7. Cultivate Optimism and Gratitude

    Optimism and gratitude are two mindset choices that draw happy feelings like a magnet. People with a grateful mindset have been the focus of numerous studies that found these people have a higher sense of belonging, higher sense of optimism, happy positive thoughts, and lower occurrence of depression, anxiety, and stress than those who don’t. 

    Choose an “attitude of gratitude”  in the various moments of the day. Watch for the silver lining. Find someone to whom you offer a helping hand or some kindness as you follow your routine. These will form the foundation for an underlying joy that makes life worth living.

    The Happiness Scientists learn more all the time about the key to happiness. It centers on many small moments of joy and reward throughout the day that accumulate to create the happiness we all seek. Surprising as it may be, it’s not what you get…it’s what you give… It’s not the big victories or bright spots that make a life happy…but the hundreds of little ones that form the fabric of happiness in your life.

    Start Today and Build a Year of Happiness

    Learning to recognize these opportunities and snatch them at a moment’s notice is a skill we train ourselves to use with keen attention and alertness. The best approach is to just start today to build an arsenal of happiness moments so that by this time next year you’re outlook on life has dramatically improved. Be your own Science of Happiness researcher.

    If you feel too listless to follow these guidelines, we might need to talk about alternative therapies. Therapies that can empower you to take steps like the ones we talk about here.  Schedule an appointment for a thorough evaluation, and we’ll take it one step at a time.

    To your emerging best self,

    Lori Calabrese, MD

    Lori Calabrese, MD offers innovative psychiatric treatment

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