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Treatment-emergent symptoms during short-term ketamine administration in treatment-resistant bipolar depression: A retrospective cross-sectional descriptive study.

Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny

Asian Journal of Psychiatry September 1, 2024 DOI: 10.1016/j.ajp.2024.104159 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational study Cross-sectional Peer reviewed
Population Treatment-resistant bipolar depression patients
Intervention intravenous ketamine infusions
Duration Eight intravenous ketamine infusions
Topics Ketamine Depression Esketamine
Keywords Bipolar depression Bipolar disorder Treatment-emergent symptoms Ketamine therapy Bipolar treatment Mental health research
Citations 8
Key findings 13.6% of patients reported new thoughts of death or suicide after eight intravenous ketamine infusions, while other common emergent symptoms included decreased appetite, increased weight, hypersomnia, and diurnal mood variation.

Abstract

Symptoms that emerge during pharmacological treatment of bipolar depression are frequently observed, underscoring the necessity for comprehensive treatment monitoring. This observational study sought to observe the correlation of eight intravenous ketamine infusions with treatment-emergent depressive symptoms in treatment-resistant bipolar depression patients who maintained their baseline psychotropic and chronic somatic treatments. Depressive symptoms were evaluated using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Treatment-emergent symptoms TES were defined as symptoms absent at baseline but present at the conclusion of the study. The most common TES included decreased appetite, increased weight, hypersomnia, and diurnal mood variation. Conversely, feelings of sadness, altered perceptions of the future, decreased interest in sex, and physical discomfort were absent in all patients. Notably, 13.6 % of patients reported thoughts of death or suicide. Larger-scale studies, integrating clinician-rated and patient-reported outcome measures, are essential to deepen our understanding of treatment-emergent symptoms. Establishing regulatory or professional definitions for treatment-emergent symptoms is warranted to improve the robustness of future research endeavors.

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