Blood pressure changes during ketamine infusion for the treatment of depression.
Mina Ansari, Brian Pittman, Daniel S Tylee, Robert Ostroff, Samuel T. Wilkinson, Sina Nikayin
General Hospital Psychiatry 2024 DOI: 10.1016/j.genhosppsych.2024.07.001 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective chart-review Peer reviewed |
|---|---|
| Sample size | 138 |
| Population | Patients with depression undergoing ketamine infusion at Yale Psychiatry Hospital |
| Intervention | Ketamine infusion |
| Duration | 7-year period |
| Topics | Esketamine Depression Ketamine |
| Keywords | Cardiovascular changes Severe hypertension Cardiovascular safety Ketamine adverse effects Blood pressure monitoring Treatment tolerability Hypertension risk |
| Citations | 6 |
| Key findings | Ketamine infusions cause significant blood pressure increases, with severe hypertension more common in older and hypertensive patients. |
Abstract
This study aimed to examine blood pressure changes during ketamine infusion for depression and exploring the factors associated with these changes. This study is a retrospective chart-review of patients with depression undergoing ketamine infusion at Yale Psychiatry Hospital during a 7-year period. Blood pressure (BP) was recorded every 10 min during the infusion. Surges in systolic and diastolic blood pressure (SBP, DBP), along with severe hypertension events, were analyzed in relation to patient demographics. A total of 138 patients received a total of 2342 infusions. SBP and DBP peaked at 40 min after the start of the infusion with a mean change of 16.0 (SD: 11.2) and 11.0 mmHg (SD: 8.45) respectively. Severe hypertension was observed in 17 patients (12.5%) and 23 infusion sessions (0.98%), occuring more frequently during the first three infusions (43.4%). Age (OR = 1.04 [1.02,1.05], p-value <0.001) was significantly associated with a surge in SBP and all patients with a past medical history of hypertension experienced a BP surge during their infusions. Ketamine infusions can cause significant blood pressure increases, particularly in older and hypertensive patients, highlighting the need for careful cardiovascular monitoring to mitigate risks during treatment.