STAT (5/24, Goldhill, Subscription Publication) reports that “when seriously depressed patients don’t respond to antidepressants, the alternatives are limited,” but researchers have “found that ketamine performs at least as well as the current gold standard for such patients, electroconvulsive therapy (ECT), suggesting it deserves consideration as a frontline response for people with treatment-resistant depression.” The research was presented at the American Psychiatric Association 2023 Annual Meeting and simultaneously published online May 24 in the New England Journal of Medicine.

MedPage Today (5/24, Monaco) reports, “The open-label trial randomized 403 patients with non-psychotic treatment-resistant major depression to either ketamine or” ECT. Investigators found that “following a 3-week treatment period, 55.4% of the patients in the ketamine group and 41.2% of those in the ECT group had a treatment response, a 14.2% difference…that fell well within the trial’s noninferiority threshold.”

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— “Ketamine is comparable to ECT for patients with treatment-resistant depression, study shows ” Olivia Goldhill, STAT, May 24, 2023

Medscape (5/24, Brooks, Subscription Publication) reports, “Securing an appointment with a mental health professional in the United States continues to be a challenge, with wait times for an in-person appointment north of two months and over one month for a telepsychiatry visit,” according to a 948-psychiatrist study that “examined general psychiatry outpatient availability during the COVID-19 pandemic in five states – New York, California, North Dakota, Virginia, and Wyoming.” The findings were presented at the American Psychiatric Association 2023 Annual Meeting. Robert Trestman, MD, chair of the APA Council on Healthcare Systems and Financing, said, “There aren’t enough primary care doctors, and there certainly aren’t enough psychiatrists.”

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— Medscape (requires login and subscription)

The Washington Post (5/24, Gilbert) reports, “U.S. authorities have seized increasing quantities of illegal ketamine, according to new research, a trend that coincides with the psychedelic drug’s rising popularity as a treatment for mental health ailments.” In fact, “the number of ketamine seizures by federal, state and local law enforcement in the United States increased from 55 in 2017 to 247 in 2022, while the total weight increased by more than 1,000 percent over that time, according to a” research letter published online May 24 in JAMA Psychiatry. The study’s lead author “sees the trend of seizures as evidence of greater recreational demand for ketamine.”

CNN (5/24, McPhillips) reports, “In addition to the risk of contamination with other potent drugs, using ketamine without medical supervision could lead to adverse outcomes, experts” contend. Gerard Sanacora, MD, PhD, “a psychiatry professor at the Yale School of Medicine,” stated, “Ketamine is possibly the major advance in the area of psychiatry in the past fifty years, but it’s not without risk.” Dr. Sanacora added, “The reality is it is an amazing treatment for many people, but we also know that it is a drug that people misuse and will abuse. And if there isn’t tight control on it, you can guarantee that it will find its way into illicit drug use.”

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— “The Washington Post (requires login and subscription)

MedPage Today (5/24, Bankhead) reports, “A measure of environmental stress had a significant association with mortality risk in patients with breast cancer, a large retrospective cohort study showed.” Investigators found that patients with a high “allosteric load” (a cumulative burden of chronic stress from life events) had almost a 50% higher all-cause mortality risk versus patients with a low “allosteric load.” MedPage Today adds, “Stratification of [allosteric load] scores showed that patients in the highest (fourth) quartile had almost an 80% greater risk than those in the lowest (first) quartile.” The findings were published in JAMA Network Open.

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— MedPage Today (requires login and subscription)

MedPage Today (5/23, Firth) reports, “Trends in prevalence of mental health diagnoses among youths differed by age and sex during the COVID-19 pandemic, with female adolescents representing ‘the most vulnerable population,’” investigators concluded after analyzing claims data. In adolescent “girls, the prevalence of anxiety disorders,” attention-deficit/hyperactivity disorder, “depression, and eating disorders all increased, with the prevalence of diagnosed eating disorders more than doubling, from 0.26% in March 2020 to 0.36% in October 2020 and 0.56% in March 2022,” the data revealed. In spite of the “‘considerably lower’ prevalence of eating disorders in males ages 13 to 18, trends were similar when compared with teen girls: 0.03% in March 2020 to 0.06% in March 2022, the authors said,” but “changes in other mental health diagnoses were not observed for teen boys.” The findings were published online May 22 in a research letter in JAMA Network Open.

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— MedPage Today (requires login and subscription)