Neurocognitive effects of repeated ketamine infusion treatments in patients with treatment resistant depression: A retrospective chart review
Danika Dai, Courtney Miller, Violeta Valdivia, Brian W. Boyle, Shuang Li, Steve Seiner, Robert C. Meisner
preprint DOI: 10.21203/rs.3.rs-1017633/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective chart review |
|---|---|
| Sample size | 22 |
| Population | Patients with treatment-resistant depression receiving serial intravenous ketamine infusions in a clinical service |
| Intervention | Ketamine |
| Duration | 8-10 repeated intravenous infusions (induction phase) |
| Measures | 16-item Quick Inventory of Depressive Symptomatology-Self Report Scale (QIDS-SR16), Montreal Cognitive Assessment (MoCA) |
| Topics | Depression Esketamine Ketamine |
| Key findings | Repeated intravenous ketamine infusions (8-10 sessions, escalating dose) produced a 47.2% reduction in depression symptoms on the QIDS-SR16 with no evidence of cognitive impairment on the MoCA. Baseline cognition showed a moderate positive association with antidepressant response (Pearson r = 0.453), suggesting it may predict treatment response. |
Abstract
Abstract BackgroundKetamine has emerged as a rapid-acting antidepressant in treatment-resistant depression (TRD) increasingly used in non-research, clinical settings. Few studies, however, have examined neurocognitive effects of repeated racemic ketamine infusion treatments in patients with TRD. In an effort to identify potential effects after serial infusions, we conducted a retrospective chart review to identify statistically significant changes in cognition in patient undergoing serial intravenous infusions; concomitantly, we examined baseline cognition as potential predictor of anti-depressant potential. MethodsTwenty-two patients with TRD were examined after they finished the induction phase of 8-10 repeated intravenous ketamine infusions and completed the assessments of their depressive symptoms (measured by the 16-item Quick Inventory of Depressive Symptomatology-Self Report Scale: QIDS-SR16) and cognitive function (measured by the Montreal Cognitive Assessment: MoCA) before the first and the last ketamine treatments. ResultsRepeated ketamine infusions administered through an escalating dose protocol with 8-10 infusion sessions produced a 47.2% reduction response in depression; there was no evidence of impairment as reflected in MoCA testing. There was a moderate association between baseline cognition and antidepressant response with a pearson correlation of 0.453. ConclusionIn this naturalistic sample of patients with TRD in our clinical service, repeated ketamine infusions significantly decreased depression symptoms without impairing cognitive performance. The baseline cognition may positively predict antidepressant responses of repeated ketamine treatment.
Comparable studies
Other observational and cohort studies on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 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 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
| Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... | 2014 | Post hoc analysis of pooled data from four studies | n = 108 |
| An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder | 2011 | Observational cohort | n = 14 |
| Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... | 2019 | Observational cohort | n = 25 |