Does body mass index predict response to intravenous ketamine treatment in adults with major depressive and bipolar disorder? Results from the Canadian Rapid Treatment Center of Excellence
Orly Lipsitz, Roger S McIntyre, Nelson B Rodrigues, Yena Lee, Hartej Gill, Mehala Subramaniapillai, Kevin Kratiuk, Flora Nasri, Rodrigo B. Mansur, Joshua D. Rosenblat
CNS Spectrums December 3, 2020 DOI: 10.1017/s1092852920002102 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective analysis Open-label Peer reviewed |
|---|---|
| Sample size | 230 |
| Population | Adults with treatment-resistant depression |
| Intervention | Intravenous ketamine |
| Duration | Four infusions |
| Topics | Anxiety Depression Ketamine Esketamine |
| Keywords | Body mass index Overweight Bipolar disorder Depression economics Suicidal ideation Mood Depressive symptoms Poison control |
| Citations | 25 |
| Key points | Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI. |
Abstract
Background: Higher body mass index (BMI) has been found to predict greater antidepressant response to intravenous (IV) ketamine treatment. We evaluated the association between BMI and response to repeat-dose IV ketamine in patients with treatment-resistant depression (TRD).
Methods: Adults (N = 230) with TRD received four infusions of IV ketamine at a community-based clinic. Changes in symptoms of depression (ie, Quick Inventory for Depressive Symptomatology-Self-Report 16; QIDS-SR16), suicidal ideation (SI; ie, QIDS-SR16 SI item), anxiety (ie, Generalized Anxiety Disorder-7 Scale), anhedonic severity (ie, Snaith-Hamilton Pleasure Scale), and functioning (ie, Sheehan Disability Scale) following infusions were evaluated. Participants were stratified by BMI as normal (18.0-24.9 kg/m2; n = 72), overweight (25-29.9 kg/m2; n = 76), obese I (30-34.9 kg/m2; n = 47), or obese II (≥35.0 kg/m2; n = 35).
Results: Similar antidepressant effects with repeat-dose ketamine were reported between BMI groups (P = .261). In addition, categorical partial response (P = .149), response (P = .526), and remission (P = .232) rates were similar between the four BMI groups.
Conclusions: The findings are limited by the observational, open-label design of this retrospective analysis. Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI.