Effects of Ketamine vs. Midazolam in Adolescent Treatment Resistant Depression.
Andrea Macejova, Veronika Kovacova, Ingrid Tonhajzerova, Zuzana Visnovcova, Nikola Ferencova, Zuzana Mlyncekova, Tomas Kukucka, Igor Ondrejka
Pharmaceuticals (Basel, Switzerland) December 4, 2024 DOI: 10.3390/ph17121627 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 55 |
| Population | Adolescent females with treatment-resistant depression |
| Intervention | Intravenous ketamine |
| Duration | 2 hours after initial infusion and 24 hours after the end of treatment |
| Topics | Depression Ketamine Esketamine |
| Keywords | Adolescent age Midazolam Novel antidepressants #mental-health mental wellness Psychological health Behavioral health #ketamine-therapy ketamine treatment Alternative depression treatment #adolescent-depression teen depression Youth mental illness |
| Citations | 7 |
| Key findings | Ketamine reduced depressive and anxiety symptoms over a short-term period and was particularly effective at alleviating inner tension compared to midazolam in adolescent females with treatment-resistant depression. |
Abstract
Background: Adolescent treatment resistant depression (TRD) is increasing in recent years. While ketamine showed rapid antidepressant effects in adult TRD studies, research on its effectiveness in adolescents is limited.
Methods: This study examines the effects of intravenous ketamine vs. midazolam on depressive and anxiety symptomatology assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), and Children's Depression Inventory (CDI) at two time points-2 h after initial infusion (T0+2h) and 24 h after the end of the treatment (Te+24h) in a sample of 55 adolescent TRD females (27 receiving ketamine, 28 midazolam).
Results: At T0+2h, within-group comparisons revealed a significant reduction in MADRS and HAM-A scores compared to baseline in the ketamine and midazolam groups. At Te+24h, both groups demonstrated similar significant reductions in MADRS, HAM-A, and CDI scores compared to baseline. The MADRS assessment in the ketamine group showed 33% and 59% responders, and in the midazolam group, 14% and 46% responders at T0+2h and Te+24h, respectively. HAM-A evaluation in the ketamine group revealed 33% and 56% responders, and in the midazolam group, 11% and 39% responders at T0+2h and at Te+24h, respectively. CDI rating discovered 11% and 44% responders in the ketamine group and 4% and 21% responders in the midazolam group at T0+2h and Te+24h, respectively. Moreover, inner tension significantly decreased in ketamine compared to the midazolam group at Te+24h.
Conclusions: Ketamine showed a reduction in depressive and anxiety symptoms during a short-term period with particular efficacy in alleviating inner tension over midazolam, suggesting its potential advantages in specific symptom relief in rarely studied adolescent TRD.
Comparable studies
Other randomized controlled trials on ketamine for depression, most cited first.