Repeated intravenous ketamine infusions are well-tolerated and associated with improvements in depression and executive function in older adults aged 60 and older with treatment-resistant depression. In a pilot trial, 25 participants received ketamine twice weekly for four weeks, with partial responders continuing weekly infusions for four more weeks. Completion rates were high (88% acute, 100% continuation), with no serious adverse events or discontinuations due to side effects. Transient blood pressure elevation, dissociation, and craving occurred but were manageable. Depressive symptoms improved significantly, with 48% of participants responding. Executive function and overall fluid cognition also improved (Cohen's d = 0.61) and were sustained.
Among older adults with treatment-resistant depression, intravenous ketamine treatment was associated with improvements in psychological well-being and sleep, but not in suicidality. The findings suggest that ketamine may enhance aspects of mental health beyond depressive symptoms in this population, though its effect on suicidal thoughts remains unclear.
Combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) is feasible and safe for older adults with subjective memory complaints and symptoms of depression or anxiety. In a pilot double-blind randomized sham-controlled trial, 26 participants received either active or sham tDCS during MBSR sessions. The largest effect sizes for active versus sham tDCS were for everyday mindfulness and social functioning, though these were not statistically significant. At-home adherence and in-class attendance varied. The authors suggest tDCS may enhance MBSR by transferring meditative learning into everyday mindfulness.