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Route of administration Depression and anxiety disorders CHAPTER 3 Ketamine Background Over the past two decades, ketamine, an uncompetitive N-­methyl-­D-­aspartate (NMDA) receptor antagonist and dissociative anaesthetic, has emerged as a novel and effective r...

Adverse effects 358 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 doses tested, in Table 3.6 we provide a summary of dosing recommendations, considering available evidence and clinical experience. Novel formulations of oral ketamine are under de...

References 360 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Berman RM, et al. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry 2000; 47:351–354. Zarate CA, Jr., et al. A randomized trial of an N-­methyl-­D-­...

Psychotic depression

Acute treatment 362 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Psychotic depression Psychotic depression represents a severe manifestation of depression. It is diagnosed in people experiencing a major depressive illness accompanied by psychot...

Ketamine formulations

ECT

Maintenance treatment Depression and anxiety disorders CHAPTER 3 Ketamine formulations Many of the more recent studies include ketamine and esketamine, which are increasingly used to treat MDD and bipolar affective disorder,16 and are possibly efficacious for ...

Other treatments

Summary

References 364 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 for 4–6 months after remission may be relatively effective at preventing a recurrence in psychotic depression.4 In the UK, NICE15 suggests continuing antipsychotic medication for a num...

Switching antidepressants

General guidelines 366 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Switching antidepressants General guidelines When changing from one antidepressant to another, abrupt withdrawal of the first drug should be avoided unless there has been a ser...

References 372 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 References Horowitz MA, et al. Estimating risk of antidepressant withdrawal from a review of published data. CNS Drugs 2023; 37:143–157. Horowitz MA, et al. Tapering of SSRI treatment...

Antidepressant withdrawal symptoms

Signs and symptoms

Incidence and severity Depression and anxiety disorders CHAPTER 3 Antidepressant withdrawal symptoms Signs and symptoms Antidepressant withdrawal symptoms may be entirely new or similar to some of the original symptoms of the illness for which the medication w...

Time course 374 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 Time course The onset and severity of symptoms are related to the half-­life of the antidepressant. Placebo/nocebo effects and loss of therapeutic efficacy may also be important. Shor...