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Role of Ketamine in Refractory Depression

Kolluri Maithri, Podalakuru Sandeep, Kota Suresh Kumar

Telangana Journal of IMA 2021 DOI: 10.52314/tjima.2021.v1i1.9 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Open-label prospective study Peer reviewed
Sample size 15
Population Adult patients (ages 18-60) with refractory depression at a tertiary care center
Intervention Ketamine
Dose 0.5 mg per kg body weight
Duration 1 week follow-up
Measures Hamilton Depression Rating Scale (HAM-D)
Topics Depression Esketamine Ketamine
Key points Intramuscular ketamine (0.5 mg/kg) led to rapid improvement in depression symptoms within 4 hours, with peak response at 48 hours and effects lasting 72 hours, but HAM-D scores returned to baseline after one week in almost all patients.

Abstract

Context: Refractory depression is seen in at least 10 to 30 percent of the patients suffering from depression. Ketamine is a new and effective option with rapid onset of action. But there are limited studies where IM Ketamine was used for treating refractory depression. Hence, this study is aimed at assessing the efficacy of IM Ketamine in patients with refractory depressionAims: To assess the efficacy of intramuscular Ketamine in adult patients with refractory depression.Settings and Design: This was study carried out at a tertiary care center. A total of 15 consecutive patients with refractory depres-sion were recruited. They were administered IM Ketamine (0.5 mg per kg body weight) and HAM D scores were recorded at baseline, after 4 hrs, 24hrs, 72 hrs, and 1 week.Methods and Material: This was an open-label prospective study. 15 subjects between the ages of 18 and 60 were evaluated to make a diagnosis of refractory depression and were recruited after obtaining informed consent. Following materials were used1. Semi-structured case record form2. Hamilton depression rating scale3. Inj. Ketamine 0.5 mg/kg. Statistical analysis used: Paired T-test and chi-square test were usedResults: Patients started improving with IM Ketamine within 4 hours, peak response attained within 48 hrs and lasted for 72 hrs. HAM D score deteriorated and reached the baseline after 1 week in almost all patients.Conclusions: IM administration of Ketamine is effective in refractory depression. It has a rapid onset of action, similar to the IV route.

Comparable studies

Other non-randomized and open-label trials on ketamine for depression, most cited first.

Study Year Design Participants
Rapid Resolution of Suicidal Ideation After a Single Infusion of anN-Methyl-D-Aspartate Antagonist in Patients With Treatment-Resistant Major Depressive Disorder Subjects with DSM-IV-diagnosed treatment-resistant major depressive disorder 2010 Open-label trial n = 33
Esketamine Nasal Spray Plus Oral Antidepressant in Patients With Treatment-Resistant Depression Adults (≥ 18 years) with treatment-resistant depression 2020 Phase 3, open-label, multicenter, long-term study n = 802
Intravenous arketamine for treatment-resistant depression: open-label pilot study Humans with treatment-resistant depression 2020 Open-label pilot trial n = 7
A Phase 2 Open Label Study of Efficacy, Safety, and Tolerability of SLS-002 (Intranasal Racemic Ketamine) in Adults with MDD at Imminent Risk of Suicide. Hospitalized patients with Major Depressive Disorder and acute suicidal ideation and... 2024 Open label study n = 17
Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression Participants with DSM-IV-defined major depressive disorder and treatment-resistant... 2014 Pooled analysis of three clinical trials n = 97

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