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Ketamine treatment for refractory anxiety: A systematic review

Tully, JL, Dahlén, AD, Haggarty, CJ, Schiöth, HB and Brooks, S (2022) Ketamine treatment for refractory anxiety: A systematic review. British Journal of Clinical Pharmacology. ISSN 0306-5251

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Abstract

There is a growing interest in the psychiatric properties of the dissociative anaesthetic ketamine, as single doses have been shown to have fast-acting mood-enhancing and anxiolytic effects, which persist for up to a week after the main psychoactive symptoms have diminished. Therefore, ketamine poses potential beneficial effects in patients with refractory anxiety disorders, where other conventional anxiolytics have been ineffective. Ketamine is a noncompetitive antagonist of the N-methyl-d-aspartate (NMDA) glutamate receptor, which underlies its induction of pain relief and anaesthesia. However, the role of NMDA receptors in anxiety reduction is still relatively unknown. To fill this paucity in the literature, this systematic review assesses the evidence that ketamine significantly reduces refractory anxiety and discusses to what extent this may be mediated by NMDA receptor antagonism and other receptors. We highlight the temporary nature of the anxiolytic effects and discuss the high discrepancy among the study designs regarding many fundamental factors such as administration routes, complementary treatments and other treatments.

Item Type: Article
Uncontrolled Keywords: anxiety; anxiolytic; depression; ketamine; ketamine infusion; refractory anxiety; treatment-resistant depression; 1115 Pharmacology and Pharmaceutical Sciences; Pharmacology & Pharmacy
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RM Therapeutics. Pharmacology
Divisions: Psychology (from Sep 2019)
Publisher: Wiley
SWORD Depositor: A Symplectic
Date Deposited: 09 Jun 2022 09:29
Last Modified: 09 Jun 2022 09:29
DOI or ID number: 10.1111/bcp.15374
URI: https://researchonline.ljmu.ac.uk/id/eprint/17026
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