Efficacy and Safety of Ketamine and Esketamine in Bipolar Depression in a Clinical Setting

Little data exists on the efficacy and safety of ketamine and esketamine as potential treatments for bipolar depression. In a small sample of patients with bipolar depression treated off-label with ketamine or esketamine, the response and remission rates were 39% and 13%, respectively. No cases of mania or hypomania emerged during the initial acute course phase (treatments given twice weekly for 2-4 weeks). Thirteen patients had manic or hypomanic events during the continuation (i.e. maintenance) treatment phase with ketamine or esketamine. Most of these events (15/16) were mild or moderate that resolved without hospitalization, during a follow-up period of 518 patient-months.

Samuel T. Wilkinson is an Associate Professor of Psychiatry at the Yale School of Medicine, where he also serves as Associate Director of the Yale Depression Research Program. Dr. Wilkinson received his B.S. in mechanical engineering from Brigham Young University and later his medical degree from Johns Hopkins School of Medicine. He completed his residency at Yale, where he joined the faculty following his post-graduate medical training.

His primary research has focused on depression and suicide prevention and has been funded by the National Institute of Mental Health, the National Institute of Drug Abuse, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention.

His research and articles have been featured in academic and other media outlets, and he has been the recipient of many awards. As a young man, he served a mission for his church in Nevada from 2002-2004, where he learned to speak fluent Spanish and to enjoy a variety of Latino cultures. He lives with his wife and their five children in southern Connecticut.

Mia C. Santucci graduated magna cum laude from Wake Forest University with a B.A. in psychology. As a summer research intern in The Ma Lab at the Geriatric Department of Wake Forest University School of Medicine, she developed a research design to examine the biochemical and behavioral effects of a protein over-expression in mice that is thought to be linked to comorbid Down Syndrome and Alzheimer’s Disease. She currently works at Yale School of Medicine in the Department of Psychiatry, as a clinical research associate at the Yale Depression Research Program. Projects include NIMH and FDA funded clinical trials, implementing different interventions both with the aim to reduce suicidality in individuals with major depressive disorder in their post-psychiatric hospitalization period. Her next step in her professional career is to pursue an education towards becoming a medical doctor. Areas of interest include psychiatry, specifically primary mood and psychotic disorders. Outside of work, Mia enjoys tutoring youth in New Haven, painting, and is currently training for the 2025 Chicago Marathon.