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IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital.

Gilmar Gutierrez, Melody J Y Kang, Gustavo Vazquez

Psychiatry Research May 1, 2024 DOI: 10.1016/j.psychres.2024.115865 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Longitudinal study Peer reviewed
Sample size 71
Population Outpatients with major depressive disorder and treatment-resistant depression
Intervention IV low-dose ketamine
Duration Five years
Topics Depression Esketamine Ketamine
Keywords Antidepressant effect Depressive symptoms Psychopharmacology Real-world clinical data Suicidal ideation Treatment response Depression treatment Ketamine therapy Mental health research Clinical psychiatry
Citations 12
Key findings Intravenous low-dose ketamine significantly reduced depressive symptoms and suicidal ideation in patients with treatment-resistant depression, with over half responding to treatment and mild side effects in most cases.

Abstract

Individuals with major depressive disorder and treatment resistant depression (MDD-TRD) have limited and sometimes poorly tolerated therapeutic options. Low dose ketamine has presented promising and potent antidepressant effects in this population. To support the existent literature, we conducted a longitudinal study examining five years of real-world clinical data on the use of IV low-dose ketamine alongside standard care for MDD-TRD outpatients. For this study we collected demographic information, clinical scale scores, side effects and dropout data. The data was analyzed using descriptive statistics, effect size using Cohen's D analysis, and multivariate ANOVA (MANOVA) to determine the impact of sociodemographic variables. 71 outpatients (50.28 years old, SD: 14.26; female 74.65%) were included in the analysis. The results showed a significant reduction in depressive symptoms and suicide ideation (SI) by treatment endpoint. 54.93% of patients responded to the treatment, 78.26% experienced transient and mild side effects, and 11.27% of dropped out of the treatment. Multivariate analysis showed that the demographic variables did not impact treatment effect or tolerability. The results of this study suggest that IV low dose ketamine treatment is effective, fast-acting, and well tolerated for the management of depressive symptoms and SI in patients with MDD-TRD in naturalistic clinical practice.

Comparable studies

Other observational and cohort studies on ketamine for depression, most cited first.

Study Year Design Participants
Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder 2012 Observational cohort n = 30
Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... 2017 Observational cohort n = 59
Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... 2014 Post hoc analysis of pooled data from four studies n = 108
An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder 2011 Observational cohort n = 14
Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... 2019 Observational cohort n = 25

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