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Age affects temporal response, but not durability, to serial ketamine infusions for treatment refractory depression

Steven Pennybaker, Brian J Roach, Susanna L Fryer, Anusha Badathala, Art W Wallace, Daniel H. Mathalon, Tobias F Marton

medRxiv Preprint Server August 31, 2020 preprint DOI: 10.1101/2020.08.31.20185538 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort
Population Veterans receiving serial intravenous ketamine infusions for treatment refractory depression
Intervention Intravenous ketamine infusions
Topics Depression Ketamine Esketamine
Keywords Age Treatment efficacy
Key findings Older age is associated with slower onset and shorter durability of ketamine's antidepressant effects in veterans with treatment-refractory depression.

Abstract

Background Ketamine is a rapid-acting treatment for patients with treatment refractory depression (TRD), however treatment responses are often transient and ketamine’s antidepressant action lacks robust clinical durability. Little is known about which patient characteristics are associated with faster or more durable ketamine responses. Ketamine’s antidepressant mechanism is proposed to involve modulation of glutamatergic signaling leading to long term potentiation (LTP) and synaptogenesis, and these neuroplasticity pathways have been shown to be attenuated with older age. We therefore investigated the impact of patient age on the speed and durability of ketamine’s antidepressant effects in veterans receiving serial intravenous ketamine infusions for TRD.

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

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