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Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic.

Vidette M Juby, Saaeda Paruk, Mitsuaki Tomita, Bonga Chiliza

South African Journal of Psychiatry 2024 DOI: 10.4102/sajpsychiatry.v30i0.2176 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Retrospective chart review Peer reviewed
Sample size 154
Population Patients attending a private ketamine clinic in Hilton, KwaZulu-Natal, South Africa for depressive symptoms
Intervention Intravenous ketamine
Duration Initial series of six infusions, with subsequent maintenance infusions; follow-up period not specified
Topics Ketamine Esketamine
Keywords Induction Intravenous Maintenance Major depression Depression therapy Ketamine treatment Mental health breakthrough Psychiatric medicine
Citations 3
Key findings Adding intravenous ketamine to usual treatment was associated with reduced depression severity and suicidal ideation, with a 60.6% response rate and 32.4% remission rate among those who completed the initial six-infusion series.

Abstract

There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses of ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting in South Africa. This retrospective chart review reports the clinical response (change in Patient Health Questionnaire - 7 score) to an initial infusion series of ketamine added to usual treatment, and the pattern of its subsequent maintenance use, for depressive symptoms. A private ketamine clinic in Hilton, KwaZulu-Natal. The medical records of all patients who attended a private ketamine clinic between August 2019 and 31 May 2021 were retrospectively analysed. Depression symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9) administered immediately before and 24 h after each treatment. Response was defined as a score decrease of more than 50%. Among the 154 patients who received ketamine infusions for depression, 67 completed a six infusion initial series, with a response rate of 60.6% and remission rate of 32.4%. Of the 154, 50% no longer experienced any suicidal ideation after treatment and adverse events were uncommon, with 6.2% of infusions requiring intervention for adverse events, mostly nausea. In addition, 48.5% of those who completed the initial series continued to receive maintenance infusions, with no evidence of escalating use or abuse. Incorporating intravenous ketamine into the existing treatment regimens at a private clinic was associated with reduced acuteness of depression severity and suicidal ideation. This approach appeared safe and tolerable, showing no signs of abuse or dependence. This is the first known naturalistic study reporting on ketamine use for depressive symptoms in South Africa.

Comparable studies

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

Study Year Design Participants
Taming the Ketamine Tiger Volunteers from a prison population 2010 Observational study n = 20
Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans 2017 Observational study
Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane Surgical patients undergoing induction of anesthesia with intravenous ketamine 2013 Observational cohort n = 30
Do the dissociative side effects of ketamine mediate its antidepressant effects? Treatment-resistant inpatients with major depressive disorder or bipolar disorder 2014 Observational cohort n = 108
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

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Ketamine Esketamine Addiction Depression