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Ketamine Treatment for Refractory Anxiety: A systematic review
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  • Jamie Tully,
  • Amelia Dahlén,
  • Connor Haggarty,
  • Helgi Schiöth,
  • Samantha Brooks
Jamie Tully
University of Exeter College of Life and Environmental Sciences

Corresponding Author:j.tully@exeter.ac.uk

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Amelia Dahlén
Uppsala University
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Connor Haggarty
Linköping University
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Helgi Schiöth
Uppsala University
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Samantha Brooks
Liverpool John Moores University
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Abstract

There is a growing interest in the psychiatric properties of the dissociative anesthetic 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 non-competitive 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. 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.
27 Oct 2021Submitted to British Journal of Clinical Pharmacology
28 Oct 2021Submission Checks Completed
28 Oct 2021Assigned to Editor
01 Nov 2021Reviewer(s) Assigned
16 Nov 2021Review(s) Completed, Editorial Evaluation Pending
16 Nov 2021Editorial Decision: Revise Major
24 Jan 20221st Revision Received
25 Jan 2022Submission Checks Completed
25 Jan 2022Assigned to Editor
25 Jan 2022Review(s) Completed, Editorial Evaluation Pending
26 Jan 2022Reviewer(s) Assigned
21 Feb 2022Editorial Decision: Revise Minor
18 Mar 20222nd Revision Received
21 Mar 2022Submission Checks Completed
21 Mar 2022Assigned to Editor
21 Mar 2022Review(s) Completed, Editorial Evaluation Pending
22 Mar 2022Reviewer(s) Assigned
11 Apr 2022Editorial Decision: Revise Minor
11 Apr 20223rd Revision Received
12 Apr 2022Submission Checks Completed
12 Apr 2022Assigned to Editor
12 Apr 2022Review(s) Completed, Editorial Evaluation Pending
13 Apr 2022Editorial Decision: Accept
04 May 2022Published in British Journal of Clinical Pharmacology. 10.1111/bcp.15374