Ketamine for treatment-resistant major depressive disorder: Double-blind active-controlled crossover study.
J Psychopharmacol
; 38(2): 162-167, 2024 02.
Article
in En
| MEDLINE
| ID: mdl-38293803
ABSTRACT
BACKGROUND:
The N-methyl-D-aspartate antagonist ketamine has rapid onset antidepressant activity in treatment-resistant depression (TRD).AIMS:
To evaluate mood rating, safety and tolerability data from patients with TRD treated with ketamine and the psychoactive control fentanyl, as part of a larger study to explore EEG biomarkers associated with mood response.METHODS:
We evaluated the efficacy and safety of intramuscular racemic ketamine in 25 patients with TRD, using a double-blind active-controlled randomized crossover design. Ketamine doses were 0.5 and 1 mg/kg, and the psychoactive control was fentanyl 50 mcg, given at weekly intervals. RESULTS/OUTCOMES:
Within 1 h of ketamine dosing, patients reported reduced depression and anxiety ratings, which persisted for up to 7 days. A dose-response profile for ketamine was noted for dissociative side effects, adverse events and changes in blood pressure; however, changes in mood ratings were broadly similar for both ketamine doses. Overall, 14/25 patients (56%) were responders (⩾50% reduction at 24 h compared with baseline) for either ketamine dose for the Hospital Anxiety and Depression Scale (HADS), and 18/25 (72%) were responders for the HADS-anxiety scale. After fentanyl, only 1/25 (HADS-depression) and 3/25 (HADS-anxiety) were responders. Ketamine was generally safe and well tolerated in this population.CONCLUSIONS:
Our findings add to the literature confirming ketamine's activity against depressive and anxiety symptoms in patients with TRD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Depressive Disorder, Major
/
Depressive Disorder, Treatment-Resistant
/
Ketamine
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
J Psychopharmacol
Journal subject:
PSICOFARMACOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Nueva Zelanda
Country of publication:
Estados Unidos