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Winstock AR. Nitrous oxide: The label 'potentially addictive' may do more harm than good. Addiction 2024; 119:623-624. [PMID: 38183384 DOI: 10.1111/add.16426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Adam Rohan Winstock
- University College London, Institute of Epidemiology and Health Care, London, UK
- Global Drug Survey, London, UK
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2
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Krystal JH, Kaye AP, Jefferson S, Girgenti MJ, Wilkinson ST, Sanacora G, Esterlis I. Ketamine and the neurobiology of depression: Toward next-generation rapid-acting antidepressant treatments. Proc Natl Acad Sci U S A 2023; 120:e2305772120. [PMID: 38011560 DOI: 10.1073/pnas.2305772120] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Ketamine has emerged as a transformative and mechanistically novel pharmacotherapy for depression. Its rapid onset of action, efficacy for treatment-resistant symptoms, and protection against relapse distinguish it from prior antidepressants. Its discovery emerged from a reconceptualization of the neurobiology of depression and, in turn, insights from the elaboration of its mechanisms of action inform studies of the pathophysiology of depression and related disorders. It has been 25 y since we first presented our ketamine findings in depression. Thus, it is timely for this review to consider what we have learned from studies of ketamine and to suggest future directions for the optimization of rapid-acting antidepressant treatment.
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Affiliation(s)
- John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Psychiatry and Behavioral Health Services, Yale-New Haven Hospital, New Haven, CT 06510
- Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Alfred P Kaye
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Sarah Jefferson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Matthew J Girgenti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Samuel T Wilkinson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Psychiatry and Behavioral Health Services, Yale-New Haven Hospital, New Haven, CT 06510
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Psychiatry and Behavioral Health Services, Yale-New Haven Hospital, New Haven, CT 06510
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
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Varì MR, Ricci G, Cavallo M, Pichini S, Sirignano A, Graziano S. Ketamine: from prescription anaesthetic to New Psychoactive Substance. Curr Pharm Des 2022; 28:1213-1220. [PMID: 35538799 DOI: 10.2174/1381612828666220510115209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/03/2022] [Indexed: 11/22/2022]
Abstract
Discovered in the United States of America (USA) in the 1960s, ketamine was introduced as an anaesthetic drug to specifically replace phencyclidine. Briefly, the substance moved from the medical world to recreational users, since it was discovered that intense psychedelic experiences were obtained with dosages lower than those prescribed for anesthesia. At the end of the 90's, circulated in London nightclubs as a drug itself and as counterfeit 3,4-methylenedioxymethamphetamine tablets. In 1997, the Drug Enforcement Administration (DEA) alerted the United States (US) government to the increasing diffusion of ketamine in American 'clubs', and in 1999, the substance was added to Schedule III of drugs controlled by federal authorities. In 2002, ketamine epidemics moved to Europe, and the European Monitoring Centre for Drugs and Drug Addiction carried out a risk assessment monitoring of the phenomenon. An estimated ninety-nine percent of all global ketamine seizures occurred in Asia. Its growing popularity is due to the fact that this new psychoactive substance is cheaper than other stimulants such as MDMA that the amount used for recreational purposes does not cause respiratory depression and its legal use as a drug makes it widely available for a diversion towards illicit markets. Nevertheless, acute intoxication and several deaths have been related to exclusive ketamine use both in Europe and internationally. Since 2015, there has been and increasing rise of the illicit ketamine market and currently the drug is being used with unprecedented peaks and a consequent significant increase in seizures and clinical cases worldwide.
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Affiliation(s)
- Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marco Cavallo
- Central Directorate for Antidrug Services, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | | | - Silvia Graziano
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
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Fitzgerald ND, Striley CW, Palamar JJ, Copeland J, Kurtz S, Cottler LB. Test-retest reliability and cross-cultural applicability of DSM-5 adopted diagnostic criteria for ketamine use disorders. Drug Alcohol Depend 2021; 228:109056. [PMID: 34592704 PMCID: PMC8678918 DOI: 10.1016/j.drugalcdep.2021.109056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite increasing prevalence of nonmedical ketamine use globally, data on ketamine use disorders, which are classified in the DSM-5 under criteria for phencyclidine, are limited. This study assessed the reliability and applicability of DSM-based diagnostic criteria for ketamine use disorder. METHODS Participants who used ecstasy were recruited through the Tri-City Study of Club Drug Use, Abuse, and Dependence in St. Louis, Miami, and Sydney. Those who reported using ketamine (lifetime use >5 times) were included in these analyses (n = 205). Participants were interviewed using the computerized Substance Abuse Module for Club Drugs (CD-SAM) at baseline and 7 days later for the reliability of diagnoses and individual diagnostic criteria. RESULTS Overall, 29.3% met DSM-5 adopted criteria for ketamine use disorder at Time 1. Moderate to excellent test-retest reliability was observed consistently across study sites for any ketamine use disorder (κ = 0.57, Y = 0.61) and severe ketamine use disorder (κ = 0.62, Y = 0.79). Continued use of ketamine despite knowledge of physical or psychological problems was the most frequently endorsed individual criterion (59.0%), followed by reported withdrawal (30.2%) and physically hazardous use (29.8%). All individual criteria had acceptable reliability estimates (κ ≥ 0.41). CONCLUSIONS Diagnoses of ketamine use disorder can be reliably evaluated using this fully structured diagnostic instrument's questions and algorithm. Ketamine-related withdrawal among people who use ketamine should be re-evaluated. Considering that after-effects of this dissociative anesthetic can last for many hours, it is important to explore a different timeframe for possible withdrawal effects.
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Affiliation(s)
- Nicole D Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA.
| | - Catherine W Striley
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
| | - Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Jan Copeland
- National Drug and Alcohol Research Centre, University of New South Wales, NDW 2052, Australia
| | - Steven Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL 33138, USA
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
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Liang H, Tang WK, Chu WCW, Ernst T, Chen R, Chang L. Striatal and white matter volumes in chronic ketamine users with or without recent regular stimulant use. Drug Alcohol Depend 2020; 213:108063. [PMID: 32498030 PMCID: PMC7686125 DOI: 10.1016/j.drugalcdep.2020.108063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies found enlarged striatum and white matter in those with stimulants use disorders. Whether primarily ketamine users (Primarily-K) and ketamine users who co-used stimulants and other substances (K+PolyS) have abnormal brain volumes is unknown. This study aims to evaluate possible brain structural abnormalities, cognitive function and depressive symptoms, between Primarily-K and K+PolyS users. METHODS Striatal and white matter volumes were automatically segmented in 39 Primarily-K users, 41 K+PolyS users and 46 non-drug users (ND). Cognitive performance in 7 neurocognitive domains and depressive symptoms were also evaluated. RESULTS Ketamine users had larger caudates than ND-controls (Right: 1-way-ANCOVA-p=0.035; K+PolyS vs. ND, p=0.030; Linear trend for K+PolyS>Primarily-K>ND, p=0.011; Left: 1-way-ANCOVA-p=0.047, Primarily-K vs. ND p=0.051) and larger total white matter (1-way ANCOVA-p=0.009, Poly+K vs. Primarily-K, p=0.05; Poly+K vs. ND p=0.011; Linear trend for K+PolyS>Primarily-K >ND, p=0.004). Across all ketamine users, they performed poorer on Arithmetic, learning and memory tasks, and were more depressed than Non-users (p<0.001 to p=0.001). Greater lifetime ketamine usage correlated with more depressive symptoms (r=0.27, p=0.008). Larger white matter correlated with better learning across all participants (r=0.21, p=0.019), while larger right caudate correlated with lower depression scores in ketamine users (r=-0.28, p=0.013). CONCLUSION Ketamine users had larger caudates and total white matter than ND-controls. The even larger white matter in K+PolyS users suggests additive effects from co-use of ketamine and stimulants. However, across the ketamine users, since greater volumes were associated with better learning and less depressive symptom, the enlarged caudates and white matter might represent a compensatory response.
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Affiliation(s)
- Huajun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Wai Kwong Tang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Winnie CW Chu
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201 USA,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21201 USA
| | - Rong Chen
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201 USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine,University of Maryland School of Medicine, Baltimore, MD, 21201, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21201, USA; Department of Neurology University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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Tang WK, Lau CG, Ungvari GS, Lin SK, Lane HY. Recovery of cognitive functioning following abstinence from ketamine. Addict Behav 2019; 99:106081. [PMID: 31470241 DOI: 10.1016/j.addbeh.2019.106081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute and adverse effects of ketamine on cognitive functioning have been documented. No longitudinal study has examined whether cognitive deficits can be reversed following ketamine abstinence although it has been suggested in some cross-sectional studies. This study aimed to investigate the changes in cognitive functioning among ketamine users following a 12-week abstinence from ketamine. METHODS In this longitudinal study, 114 ketamine users completed clinical and cognitive assessments at both baseline and 12-week follow-up with the following instruments: Severity of Dependence Scale, Beck Depression Inventory (BDI), Anxiety Subscale of the Hospital Anxiety Depression Scale (HADSA), and a cognitive battery. RESULTS BDI (p < 0.001) and HADSA (p = 0.044) scores were significantly reduced at the 12-week follow-up. Significant improvements were found in Wechsler Adult Intelligence Scale (Third edition) immediate recall (p < 0.001) and delayed recall (p < 0.001) on the Rey-Osterrieth Complex Figure Test, and in delayed recall (p < 0.001), and immediate recall (p = 0.001) on the Logical Memory component of the Wechsler Memory Scale (Third Edition) at the 12-week follow-up. Participants completed the Stroop Inference Test significantly faster (p < 0.001); and required fewer number of attempts (p < 0.001) and produced fewer perseverative errors (p < 0.001) on the Wisconsin Card Sorting Test at the 12-week follow-up. CONCLUSION Chronic ketamine users' verbal and visual memory and executive functions improved after 12 weeks of ketamine abstinence.
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Affiliation(s)
- Wai Kwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.
| | - Chieh Grace Lau
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Gabor S Ungvari
- Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia; Section of Psychiatry, University Notre Dame Australia, Fremantle, Australia
| | - Shih-Ku Lin
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Taipei City Hospital, Taipei, Taiwan
| | - Hsien-Yuan Lane
- Department of Psychiatry, China Medical University Hospital, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Chen L, Chen C, Chen C, Chang H, Huang M, Xu K. Association of Craving and Depressive Symptoms in Ketamine‐Dependent Patients Undergoing Withdrawal Treatment. Am J Addict 2019; 29:43-50. [DOI: 10.1111/ajad.12978] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/18/2019] [Accepted: 10/20/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lian‐Yu Chen
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
- Institute of Epidemiology and Preventive MedicineNational Taiwan University Taipei Taiwan
- Kunming Prevention and Control CenterTaipei City Hospital Taipei Taiwan
| | - Chih‐Ken Chen
- Department of Psychiatry & Community Medicine Research CenterChang Gung Memorial Hospital Keelung Taiwan
- Chang Gung University School of Medicine Taoyuan Taiwan
| | - Chun‐Hsin Chen
- Department of Psychiatry, Wan‐Fang HospitalTaipei Medical University Taipei Taiwan
- Department of Psychiatry, School of Medicine, College of MedicineTaipei Medical University Taipei Taiwan
- Psychiatric Research Center, Wang‐Fang HospitalTaipei Medical University Taipei Taiwan
| | - Hu‐Ming Chang
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
| | - Ming‐Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
- Department of Psychiatry, School of Medicine, College of MedicineTaipei Medical University Taipei Taiwan
- Psychiatric Research Center, Wang‐Fang HospitalTaipei Medical University Taipei Taiwan
- Psychiatric Research CenterTaipei Medical University Hospital Taipei Taiwan
| | - Ke Xu
- Department of PsychiatryYale University School of Medicine New Heaven Connecticut
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Freeman MP, Papakostas GI, Hoeppner B, Mazzone E, Judge H, Cusin C, Mathew S, Sanacora G, Iosifescu D, DeBattista C, Trivedi MH, Fava M. Sex differences in response to ketamine as a rapidly acting intervention for treatment resistant depression. J Psychiatr Res 2019; 110:166-171. [PMID: 30641350 PMCID: PMC6360121 DOI: 10.1016/j.jpsychires.2019.01.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND While ketamine has been increasingly studied for treatment resistant depression (TRD), the impact of sex differences on treatment outcomes has not been well studied. The objective was to ascertain whether there were differences in response to a single administration of ketamine for TRD between men and women, and between pre- and post-menopausal women. METHODS A randomized, double-blind, placebo-controlled trial (N = 99; N = 50 male; N = 49 female) was conducted to investigate the efficacy of intravenous ketamine versus active placebo as augmentation of antidepressant therapy for TRD. Patients were assigned to one of five arms; one-time administration of ketamine of varying doses (i.e., 0.1, 0.2, 0.5, and 1.0 mg/kg), and one group receiving active placebo (intravenous midazolam). A priori-planned analyses were conducted to compare responses between women and men, as well pre-vs. postmenopausal women. RESULTS Analyses demonstrated no significant differences between women and men in terms of treatment response (F(1,80) = 0.06, p = 0.80). There were no significant differences in the frequency of adverse effects (AEs) reported by those assigned to ketamine treatment groups (p > 0.21 for all AEs reported more than once), although women reported more headaches (12% vs. 6%, p = 0.30) and nausea (10% vs. 6%, p = 0.47). In comparing pre-vs. postmenopausal women, no differences in efficacy were observed (F(1,76) = 0.36, p = 0.55). CONCLUSIONS Results do not support differential efficacy or tolerability of ketamine for the treatment of TRD between women and men, nor based on menopause status among women. However, larger trials with these a priori aims are needed to confirm these results.
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Affiliation(s)
| | | | | | | | | | | | - Sanjay Mathew
- Baylor College of Medicine/Michael E. Debakey VA Medical Center, USA
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Abstract
SummaryKetamine, a synthetic derivative of phencyclidine, is a commonly misused party drug that is restricted in high-income countries because of its addictive potential. Ketamine is also used as an anaesthetic in human and veterinary medicine. In the 1990s, research using ketamine to study the pathophysiology of schizophrenia was terminated owing to ethical concerns. Recently, controversy surrounding the drug has returned, as researchers have demonstrated that intravenous ketamine infusion has a rapid antidepressant effect and have therefore proposed ketamine as a novel antidepressant. This article debates the question of ketamine as an antidepressant, considering the drug's addictive potential, ethical concerns about prescribing a hallucinogen, the evidence base and motives behind ketamine trials.
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Liao Y, Tang J, Liu J, Xie A, Yang M, Johnson M, Wang X, Deng Q, Chen H, Xiang X, Liu T, Chen X, Song M, Hao W. Decreased Thalamocortical Connectivity in Chronic Ketamine Users. PLoS One 2016; 11:e0167381. [PMID: 27977717 PMCID: PMC5157971 DOI: 10.1371/journal.pone.0167381] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 11/14/2016] [Indexed: 12/03/2022] Open
Abstract
Disintegration in thalamocortical integration suggests its role in the mechanistic 'switch' from recreational to dysregulated drug seeking/addiction. In this study, we aimed to address whether thalamic nuclear groups show altered functional connectivity within the cerebral cortex in chronic ketamine users. One hundred and thirty subjects (41 ketamine users and 89 control subjects) underwent rsfMRI (resting-state functional Magnetic Resonance Imaging). Based on partial correlation functional connectivity analysis we partitioned the thalamus into six nuclear groups that correspond well with human histology. Then, in the area of each nuclear group, the functional connectivity differences between the chronic ketamine user group and normal control group were investigated. We found that the ketamine user group showed significantly less connectivity between the thalamic nuclear groups and the cortical regions-of-interest, including the prefrontal cortex, the motor cortex /supplementary motor area, and the posterior parietal cortex. However, no increased thalamic connectivity was observed for these regions as compared with controls. This study provides the first evidence of abnormal thalamocortical connectivity of resting state brain activity in chronic ketamine users. Further understanding of pathophysiological mechanisms of the thalamus in addiction (ketamine addiction) may facilitate the evaluation of much-needed novel pharmacological agents for improved therapy of this complex disease.
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Affiliation(s)
- Yanhui Liao
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
- Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, United States of America
| | - Jinsong Tang
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
- Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, United States of America
| | - Jianbin Liu
- Department of Radiology, The People's Hospital of Hunan Province, Changsha, China
| | - An Xie
- Department of Radiology, The People's Hospital of Hunan Province, Changsha, China
| | - Mei Yang
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
- Department of Addiction Medicine, Hunan Brain Hospital, Changsha, China
- Department of Addiction Medicine, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Maritza Johnson
- Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, United States of America
| | - Xuyi Wang
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Qijian Deng
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Hongxian Chen
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Xiaojun Xiang
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Tieqiao Liu
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Xiaogang Chen
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Ming Song
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences Beijing, China
| | - Wei Hao
- Institute of Mental Health of the Second Xiangya Hospital of Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
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Tang WK, Liang H, Lin Y, Zhang C, Tang A, Chan F, Freeman TP, Ungvari GS. Psychiatric Co-morbidity in Ketamine and Methamphetamine Dependence: a Retrospective Chart Review. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9681-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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12
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Fernández-Calderón F, Vidal-Giné C, López-Guerrero J, Lozano-Rojas ÓM. Reliability, convergent and structural validity and cut-off score of the Severity of Dependence Scale for recreational ketamine users. Addict Behav 2016; 60:1-7. [PMID: 27082261 DOI: 10.1016/j.addbeh.2016.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 01/27/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS There is a lack of instruments for measuring ketamine substance use disorders. The aims were (i) to estimate the reliability and provide evidence of validity of the Severity of Dependence Scale (SDS) in a sample of recreational users, and (ii) propose a cut-off point to determine the presence of dependence. METHODS We conducted a web-based cross-sectional survey with recreational users who accessed webs related to recreational drug use and harm reduction. 264 recreational ketamine users who had taken it in the past month participated in the study. The Spanish version of the SDS was used. Information on ketamine use-related problems and ketamine use patterns was also collected. RESULTS The reliability estimation calculated by the Cronbach's alpha coefficient was 0.776. SDS showed evidence of convergent validity based on relationships with other variables. Two comparisons were made in this study to analyze the Receiver Operating Characteristic Curve. For frequency of use in the last month the area under curve (AUC) was 0.835 (CI=0.775-0.895) with optimal discrimination at an SDS score of 3. For having been in treatment for decreasing or quitting ketamine use the AUC was 0.902 (CI=0.840-0.963) and the cut-off point was 4. Confirmatory factor analysis showed a one-dimensional structure when Items 3 and 4 were correlated. CONCLUSIONS This study has provided evidence of reliability and validity of the ketamine version of the SDS for recreational users. Considering that ketamine use is linked to young people and its strong potential for causing serious impairment, a cut-off of 3 is proposed as indicative of dependence.
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Zhang MW, Ho RC. Ethical Considerations for Clinical Research and Off-label Use of Ketamine to Treat Mood Disorders: The Balance Between Risks and Benefits. ETHICS & BEHAVIOR 2016. [DOI: 10.1080/10508422.2016.1189333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Melvyn W. Zhang
- Biomedical Global Institute of Healthcare Research and Technology (BIGHEART), National University of Singapore
| | - Roger C. Ho
- Department of Psychological Medicine, National University of Singapore
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Fan N, Xu K, Ning Y, Rosenheck R, Wang D, Ke X, Ding Y, Sun B, Zhou C, Deng X, Tang W, He H. Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users. Psychiatry Res 2016; 237:311-5. [PMID: 26805565 PMCID: PMC4906312 DOI: 10.1016/j.psychres.2016.01.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/30/2015] [Accepted: 01/13/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although concern about chronic ketamine abuse has grown, the characteristic symptomatology of chronic ketamine users has yet to be examined. This study aims to measure the psychotic, depressive and anxiety symptoms in chronic ketamine users. METHODS A group of chronic ketamine users in Guangzhou, China were evaluated. The socio-demographic and drug use characteristics of subjects were documented. Symptoms of psychosis, depression, anxiety were evaluated by the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The severity of the symptoms was identified by standard severity cutoffs. RESULTS The PANSS total score, positive symptom, negative symptom, general psychopathology subscale score were 45.3±8.4, 8.0±1.7, 13.2± 3.9 and 24.2± 4.9 respectively. BDI and BAI score was 13.1±6.5 and 15.7±9.6 respectively. 77.5% and 46.0% of the subjects showed moderate to severe depressive symptoms and anxiety symptoms respectively. The BDI score was positively correlated with ketamine use frequency. The BAI score was positively correlated with ketamine use frequency. CONCLUSIONS Depressive symptoms were commonly presented in chronic ketamine users. The higher ketamine use frequency and dosage were associated with more severe depressive symptoms.
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Affiliation(s)
- Ni Fan
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Ke Xu
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Yuping Ning
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Daping Wang
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Xiaoyin Ke
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Yi Ding
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Bin Sun
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Chao Zhou
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China
| | - Xuefeng Deng
- Guangzhou Baiyun Mental Hospital, 586 North of Baiyun Road, Baiyun District, Guangzhou, Guangdong 510440, China
| | - Waikwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Hongbo He
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong Province 510370, China.
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