Single arketamine in treatment resistant depression: Presentation of 3 cases with regard to sick-leave duration.
Adam Włodarczyk, Jakub Słupski, Joanna Szarmach, Wiesław Jerzy Cubała
Asian Journal of Psychiatry June 1, 2024 DOI: 10.1016/j.ajp.2024.104016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 3 |
| Population | Adults with recurrent major depressive disorder without psychotic features and treatment-resistant depression |
| Intervention | Arketamine (R-KET) |
| Duration | Year-long follow-up |
| Topics | Depression Ketamine |
| Keywords | Follow-up Sick-leave Mental health Treatment-resistant depression trd Therapy-resistant depression Arketamine r-ketamine Ketamine isomer Workplace reintegration return-to-work Sick leave Disability leave Clinical outcomes |
| Citations | 12 |
| Registration | NCT05414422 NCT06232291 |
| Key findings | Arketamine administration was associated with significant symptom reduction and improved social and vocational functioning in three TRD patients, though one case developed a substance use disorder. |
Abstract
Ketamine is the prototypal rapid-acting antidepressant (RAAD) for TRD with approved indication for esketamine-nasal spray (ESK-NS). Distinctly, arketamine (R-KET) demonstrates enhanced antidepressant effects and neuroplasticity changes compared to esketamine, with fewer dissociative side effects and abuse potential. This study focuses on R-ketamine's therapeutic implications, safety, and tolerability in TRD treatment. We report on a year-long follow-up of three TRD patients post-single IV R-KET administration. The study, conducted under the clinical trial PCN-101 (NCT05414422), observed these subjects for healthcare resource utilization and social support system impact. Participants, adults diagnosed with recurrent major depressive disorder without psychotic features, were observed in a year-long follow-up period for safety. Case analyses revealed significant symptom reduction and improved social and vocational functioning, with reduced sick leaves and hospitalizations post-treatment. However, one case developed a substance use disorder, underscoring the need for vigilant monitoring. The study highlights R-KET's transformative potential in managing depression, indicating a shift in TRD treatment strategies towards early, aggressive interventions. Despite promising findings, the study faces limitations due to its small sample size, lack of randomization, and potential observational design biases. The results, while aligning with existing ketamine research, require cautious interpretation and warrant further investigation with larger, more robust studies. This exploration of R-KET's role in home-based TRD treatment opens avenues for future research, particularly focusing on its long-term effectiveness and safety in diverse patient populations. This study is registered in clinicaltrials.gov: NCT06232291.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.