Comparative effectiveness of repeated ketamine infusions in treating anhedonia in bipolar and unipolar depression.
Wei Zheng, Lingna Gu, Chen-Hui Sun, Yanling Zhou, Chengyu Wang, Xiaofeng Lan, Bin Zhang, Y. Ning
Journal of Affective Disorders December 1, 2021 DOI: 10.1016/j.jad.2021.12.105 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label study Peer reviewed |
|---|---|
| Sample size | 97 |
| Population | Chinese individuals with major depressive disorder (MDD, n=77) or bipolar depression (BD, n=20) |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg |
| Duration | Six infusions over 40 minutes each; follow-up at 4 hours after first infusion and one day after sixth infusion |
| Measures | Montgomery-Åsberg Depression Rating Scale (MADRS) anhedonia subscale |
| Topics | Depression Esketamine Ketamine |
| Key points | Six intravenous ketamine infusions (0.5 mg/kg) produced antianhedonic response in 48.5% and remission in 30.9% of patients, with significant reduction in anhedonia scores from 4 hours after the first infusion, maintained at all time points, and similar efficacy between MDD and BD. |
Abstract
Objectives: Anhedonia is a common, persistent, and disabling phenomenon in patients with major depressive disorder (MDD) and bipolar depression (BD). This study was conducted to investigate the comparative effectiveness of repeated ketamine infusions in treating anhedonia in Chinese individuals suffering from MDD and BD.
Methods: Ninety-seven individuals suffering from MDD (n=77) or BD (n=20) were treated with six intravenous infusions of ketamine (0.5 mg/kg) administered over 40 min. Anhedonia was measured through the Montgomery-Åsberg Depression Rating Scale (MADRS). The antianhedonic response and remission were defined as ≥ 50% and ≥ 75% reduction in MADRS anhedonia subscale score one day after the sixth infusion, respectively.
Results: Anti-anhedonic response and remission rates after the sixth ketamine infusion were 48.5% (95% confidence interval=38.3-58.6) and 30.9% (95% confidence interval=21.6-40.3), respectively. When compared to baseline, a significant reduction in the MADRS anhedonia subscale score was observed at 4 h after the first infusion and was maintained with repeated infusions at any time point (all Ps<0.05). The anti-anhedonic effect of ketamine did not differ between the MDD and BD groups.
Conclusion: This preliminary study found that repeated ketamine infusions appeared to be effective at rapidly ameliorating anhedonia, with similar efficacy in MDD and BD.