Ketamin in therapy of pharmacoresistent depressions in patients with double diagnosis (naturalistic study)

Pharmacotherapy of depression based on a monoaminergic model in many cases is not enough effective. In this regard the ketamine treatment results of pharmacoresistant depression by subanaesthetic doses, including the patients with double diagnosis, are of interest.

Method: in an open label naturalistic non-randomized trial, 12 patients with non-psychotic treatment-resistant depression (10 of whom had concomitant addictive disorder), 6 sessions of ketamine therapy (0.5 - 0.75 mg/kg intravenously) were undertaken. Clinical and psychometric (Beck scale, visual analogue scale and scale of general clinical impression) assessment were used. Statistical processing - general linear model and nonparametric criterion.

Results: the effectiveness of therapy was noted in 11 of 12 respondents, and in 7 ones the improvement was qualified as significant. The total scores of the scales applied corresponded to 50% reduction of depressive symptoms (p0.05).

Conclusions: ketamine proved to be an effective and safe method of the fast achieving therapeutic effect in patients with therapeutically-resistant depression. However insufficiently representative sample, the lack of a control group and the mechanism of randomization and the open nature of the study limit the wide extrapolation of the results.