This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine and second-generation "ketamine-like" fast-acting antidepressants.Currently available antidepressant medications act through monoaminergic systems, are ineffective for many individuals suffering from depression, and are associated with a delayed onset of peak efficacy of several months. The unexpected emergence of ketamine, an anesthetic N-methyl-D-aspartate (NMDA) receptor antagonist, as a rapid-acting antidepressant has reinvigorated CNS drug discovery research and catalyzed investigation in patient populations historically ignored in antidepressant drug development programs, particularly treatment-resistant patients and those with suicidality. Recent industry and academic research efforts have coalesced to explore NMDA receptor and glutamatergic molecular targets that lack ketamine's psychotomimetic side effects and abuse liability but retain its rapid onset of efficacy. However, many fundamental questions remain regarding the neurobiological mechanisms underlying ketamine's rapid antidepressant effects and the puzzling persistence of benefits observed in some patients following a single dose. This book examines how insights from these studies are forging new conceptual models of the neurobiology of stress-related affective, anxiety, and addictive disorders and the nature of treatment resistance. It also discusses how ketamine's rapid antidepressant effects provide a scientific platform to facilitate innovation in clinical trial designs pertaining to patient selection, choice of control group, outcome measures, and dose-optimization. This book brings together data and insights from this rapidly expanding and extraordinarily promising field of study. Readers will be able to extract integrated themes and useful insights from the material contained in these diverse chapters and appreciate the paradigm-shifting contributions of ketamine to modern psychiatry and clinical neuroscience research.
This book offers the most up-to-date information about research surrounding the neurobiology of bipolar disorder as well as currently available and novel therapeutic options. The volume has assembled a widely respected group of preclinical and clinical researchers who bring their expertise to bear upon this illness by reviewing cutting-edge research and clinical evidence regarding the pathophysiology and treatment of bipolar disorder. Early chapters review the course and outcome and genetics of this highly heritable condition, including chapters on epigenetics and clinical endophenotypes. Several chapters offer a remarkably thorough and unique overview of the neurobiology of the disorder, including what is known from neuroimaging work and the development of animal models. Finally, the book covers treatment strategies for bipolar disorder, including both traditional and novel therapeutics, as well as non-pharmacological treatments. It offers both researchers and clinicians key insights into this devastating disorder.
This book brings together mental health professionals and researchers to offer the most up-to-date information on the diagnosis, treatment, and research surrounding bipolar depression. Its individual chapters provide valuable diagnostic information, allowing clinicians to distinguish between the various mood disorders. Further, they: review the course, outcome, and genetics of this highly heritable condition; offer a thorough overview of the neurobiology of the disorder, including what is known from neuroimaging work; delineate the treatment of bipolar depression in special populations such as children and pregnant women; address suicide, focusing on the need for assessment during both acute and maintenance treatment with interventions appropriate to a patient's symptoms and history; and cover acute and long-term treatment strategies for bipolar depression, including both traditional and novel therapeutics for the disorder, as well as non-pharmacological treatments.This second edition reflects significant advances, including an improved understanding of the altered neurobiology of patients suffering from bipolar depression, new information on pathophysiology and genetic findings drawn from diverse studies, and a discussion of the significant strides made towards improved treatment with already available and novel agents.