Effects of low-dose ketamine infusion on vascular endothelial growth factor and matrix metalloproteinase-9 among patients with treatment-resistant depression and suicidal ideation.
Mu-Hong Chen, Wei-Chen Lin, Cheng-Ta Li, Hui-Ju Wu, Ya-Mei Bai, S. Tsai, T. Su, P. Tu
Journal of Psychiatric Research July 1, 2023 DOI: 10.1016/j.jpsychires.2023.07.022 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 48 |
| Population | Patients with treatment-resistant depression and strong suicidal ideation |
| Interventions | Ketamine Midazolam |
| Dose | 0.5-mg/kg ketamine, 0.045-mg/kg midazolam |
| Duration | Single infusion, with assessments at several postinfusion timepoints and blood analysis on day 3 postinfusion |
| Topics | Depression Esketamine Ketamine |
| Citations | 8 |
| Key findings | A single low-dose ketamine infusion did not alter VEGF or MMP-9 levels, but higher baseline VEGF levels were associated with greater antidepressant and antisuicidal effects. |
Abstract
Background: Evidence indicates that vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) influence the pathophysiology of depression. However, whether low-dose ketamine regulates VEGF and MMP-9 levels and whether changes in VEGF and MMP-9 levels are associated with the antidepressant and antisuicidal effects of ketamine remained unclear.
Methods: Forty-eight patients with treatment-resistant depression and strong suicidal ideation (TRD-SI) were randomly assigned to a single infusion of 0.5-mg/kg ketamine or 0.045-mg/kg midazolam. The Montgomery-Åsberg Depression Rating Scale (MADRS) and Columbia-Suicide Severity Rating Scale-Ideation Severity Subscale (CSSRS-ISS) were used at baseline and subsequently at several postinfusion timepoints. VEGF and MMP-9 serum levels were analyzed at baseline and on day 3 postinfusion.
Results: After adjustment for baseline levels, no significant differences in VEGF (p = .912) and MMP-9 (p = .758) levels were identified on day 3 postinfusion between the study groups. Baseline VEGF levels but not MMP-9 levels were negatively associated with MADRS and CSSRS-ISS scores following infusion.
Discussion: A single infusion of low-dose ketamine did not alter the VEGF and MMP-9 levels of the patients with TRD-SI. Higher baseline VEGF levels were associated with greater antidepressant and antisuicidal effects of single low-dose ketamine infusion.
Comparable studies
Other randomized controlled trials on ketamine for depression, most cited first.