Comparison of racemic ketamine and S-ketamine in treatment-resistant major depression: report of two cases.
Robert Paul, Nadine Schaaff, Frank Padberg, Hans-Jürgen Möller, Thomas Frodl
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry 2009 DOI: 10.1080/15622970701714370 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Patients with treatment-resistant major depression |
| Interventions | Ketamine S-ketamine |
| Measures | Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI) |
| Topics | Depression Esketamine Ketamine |
| Key findings | In one of two patients, both ketamine and S-ketamine infusions reduced depression scores at days 1 and 3, with effects fading by day 6; the other patient did not respond. Both patients had psychomimetic side effects with ketamine but not with S-ketamine, suggesting S-ketamine may be better tolerated. |
Abstract
Recent studies with intravenous infusion of the NMDA receptor antagonist ketamine showed robust and rapid antidepressant effects within hours after treatment. Ketamine is a racemic mixture consisting of two enantiomers, R- and S-ketamine. In contrast to ketamine, S-ketamine is reported to be less prone to psychomimetic side effects, such as derealisation and hallucinations. In this report we describe the effect of ketamine and S-ketamine infusion therapy, respectively, in two patients with treatment-resistant major depression. Severity of depression was rated using the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI). While one patient did not respond to either treatment, in the other patient intravenous administration of ketamine as well as S-ketamine showed an antidepressant effect as assessed by a decrease in HAMD-21 and BDI at days 1 and 3 after infusion which faded until day 6. Both patients experienced psychomimetic side effects during ketamine infusion which were absent during treatment with S-ketamine. We conclude that S-ketamine might exert similar antidepressant effects as ketamine in drug-resistant depression but may be better tolerated by the patients.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.