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Intravenous ketamine therapy in a patient with a treatment-resistant major depression

Michael Liebrenz, Alain Borgeat, R Leisinger

Swiss Medical Weekly April 21, 2007 DOI: 10.4414/smw.2007.11852 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Open label trial Open-label Peer reviewed
Sample size 1
Population 55-year-old male with treatment-resistant major depression and co-occurring alcohol and benzodiazepine dependence
Intervention Ketamine hydrochloride
Dose 0.5 mg/kg
Duration 50-minute infusion, assessed at 1 hour, 1 day, 2 days, and 7 days post-infusion
Topics Depression Esketamine Ketamine
Citations 75
Key findings A single intravenous ketamine infusion produced rapid and sustained antidepressant effects in a patient with treatment-resistant depression and co-occurring substance use disorders.

Abstract

Background: Recently, reports from North America have indicated that the intravenous infusion of ketamine hydrochloride (an N-methyl-d-aspartate receptor antagonist) results in a sudden and robust improvement of depression symptoms.

Objective: To corroborate antidepressant effectiveness of IV ketamine in a patient with a co-occurring substance use disorder for the first time in a European clinical setting.

Design: Open label trial

Methods: A 55-year-old male subject with a treatment-resistant major depression and a co-occurring alcohol and benzodiazepine dependence received an intravenous infusion of 0.5 mg/kg ketamine over a period of 50 minutes. Effects were assessed by means of a clinical interview, the 21-item Hamilton Depression Rating scale (HDRS), and the 21-item Beck Depression Inventory (BDI) at baseline, 1 hour, 1 day, 2 days, and 7 days after intervention.

Results: Following the administration of ketamine the subject experienced a significant improvement of his symptoms peaking on the 2nd day post infusion (HDRS from 36 to 16; -56.6%, BDI from 26 to 9; -65.4%). The subject first reported improvements 25 min. into the infusion and continued to describe positive effects throughout the subsequent 7 days.

Conclusion: Ketamine not only seems to have strong antidepressant effects but also to act very swiftly. These actions were unaffected by an alcohol or benzodiazpine dependence.

Comparable studies

Other non-randomized and open-label trials on ketamine for depression, most cited first.

Study Year Design Participants
Rapid Resolution of Suicidal Ideation After a Single Infusion of anN-Methyl-D-Aspartate Antagonist in Patients With Treatment-Resistant Major Depressive Disorder Subjects with DSM-IV-diagnosed treatment-resistant major depressive disorder 2010 Open-label trial n = 33
Esketamine Nasal Spray Plus Oral Antidepressant in Patients With Treatment-Resistant Depression Adults (≥ 18 years) with treatment-resistant depression 2020 Phase 3, open-label, multicenter, long-term study n = 802
Intravenous arketamine for treatment-resistant depression: open-label pilot study Humans with treatment-resistant depression 2020 Open-label pilot trial n = 7
A Phase 2 Open Label Study of Efficacy, Safety, and Tolerability of SLS-002 (Intranasal Racemic Ketamine) in Adults with MDD at Imminent Risk of Suicide. Hospitalized patients with Major Depressive Disorder and acute suicidal ideation and... 2024 Open label study n = 17
Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression Participants with DSM-IV-defined major depressive disorder and treatment-resistant... 2014 Pooled analysis of three clinical trials n = 97

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