Skip to content

Does oral administration of ketamine accelerate response to treatment in major depressive disorder? Results of a double-blind controlled trial.

Somaye Arabzadeh, Elham Hakkikazazi, Nazila Shahmansouri, Abbas Tafakhori, Alireza Ghajar, Morteza Jafarinia, Shahin Akhondzadeh

Journal of Affective Disorders August 1, 2018 DOI: 10.1016/j.jad.2018.02.056 (opens in new tab)

Read Full Text
Relevant Not relevant

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Double-blind Peer reviewed
Sample size 81
Population Patients with major depressive disorder
Interventions Oral ketamine sertraline
Duration 6 weeks
Measures Hamilton Depression Rating Scale (HDRS)
Topics Depression Esketamine Ketamine
Keywords Adjunctive therapy Hdrs Oral ketamine
Key findings Oral ketamine combined with sertraline significantly reduced Hamilton Depression Rating Scale scores at 2, 4, and 6 weeks compared with placebo plus sertraline, with early improvement in 85.4% of the ketamine group versus 42.5% of the placebo group. The authors suggest oral ketamine may be a suitable adjunct to sertraline for relieving depressive symptoms, while noting that six-week follow-up cannot reveal long-term adverse effects or sustainability of benefit.

Abstract

Major depressive disorder (MDD) exerts a high health and financial burden on society. The conventional pharmacotherapies for MDD are partially effective and the response to medication often starts with some delay. There are recent reports of antidepressant effects for oral ketamine. We employed a double-blind controlled trial to examine the time course of the therapeutic effect of ketamine when combined with the conventional administration of sertraline. A total of 81 patients participated in the study and were scored with the Hamilton Depression Rating Scale (HDRS) at baseline and at 2, 4 and 6 weeks after the start of the trial RESULTS: General linear model repeated measures demonstrated significant effect for time × treatment interaction on the HDRS scores, with significant difference at all time points post treatment. Early improvement was significantly greater in the ketamine group (85.4%) compared to the placebo group (42.5%). We did not observe any side effects for ketamine administration. Our follow up was limited to 6 weeks post initiation of treatment and cannot reveal the potential long-term adverse effects of oral ketamine and the sustainability of its benefit. Altogether, our results suggest that oral ketamine may be considered as suitable adjuvant to sertraline in relieving depressive symptoms.

Comparable studies

Other randomized controlled trials on ketamine for depression, most cited first.

Study Year Design Participants
Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode 2013 Randomized controlled trial n = 73
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study Adults with moderate to severe nonpsychotic depression and a history of nonresponse to... 2019 Phase 3, double-blind, active-controlled, multicenter randomized controlled trial n = 227
Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression Adults with treatment-resistant depression who achieved stable remission or stable... 2019 Phase 3, multicenter, double-blind, randomized withdrawal study n = 297
Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression Adults with DSM-IV-TR diagnosis of major depressive disorder and history of inadequate... 2017 Phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study n = 67
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study Depressed patients at imminent risk for suicide 2018 Randomized controlled trial n = 68

Citations in the library

Cited by 53

and 48 more in the library

Cites 17

and 12 more in the library

Related reading

Explore topics

Depression Esketamine Ketamine

By condition and practice

Ketamine for depression