Psych Vivas · Psychopharmacology — ketamine and esketamine
Ketamine and esketamine — consultant viva
Fellowship viva covering TRD entry, IV vs IN protocols, trial names, safety, SI populations, and ECT comparison.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner places cards: 0.5 mg/kg, TRANSFORM-2, SUSTAIN-1, ASPIRE, ELEKT-D, aneurysm history, unsupervised take-home spray, dissociation in recovery.
Station structure
Time: 8–10 minutes. Depth: consultant teaching registrar. Expect named trials, dose scaffolds, and safety protocols without inventing local funding codes as universal law.[7]
References8ShowHide
- [1]Zarate CA Jr, Singh JB, Carlson PJ, et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry, 2006.PMID 16894061
- [2]Murrough JW, Iosifescu DV, Chang LC, et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry, 2013.PMID 23982301
- [3]Popova V, Daly EJ, Trivedi M, et al. Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study. Am J Psychiatry, 2019.PMID 31109201
- [4]Daly EJ, Trivedi MH, Janik A, et al. Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression: A Randomized Clinical Trial. JAMA Psychiatry, 2019.PMID 31166571
- [5]Fu DJ, Ionescu DF, Li X, et al. Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent: Double-Blind, Randomized Study (ASPIRE I). J Clin Psychiatry, 2020.PMID 32412700
- [6]Anand A, Mathew SJ, Sanacora G, et al. Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression. N Engl J Med, 2023.PMID 37224232
- [7]McIntyre RS, Rosenblat JD, Nemeroff CB, et al. Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation. Am J Psychiatry, 2021.PMID 33726522
- [8]Li N, Lee B, Liu RJ, et al. mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists. Science, 2010.PMID 20724638