Efficacy of Oral Ketamine Combined with Psychotherapy for Treatment Resistant Depression
European Journal of Medical and Health Sciences August 5, 2021 Peer reviewed DOI: 10.24018/ejmed.2021.3.4.979
Summary
Patients with treatment resistant depression (TRD) showed significant improvement after receiving low dose ketamine combined with the TRIP psychotherapeutic intervention. Their average PHQ9 score decreased from 17.9 at baseline to 9.5 post-treatment, representing a 46.9% reduction in symptoms. This pilot study involved 10 adult patients and indicates that combining these treatments may be effective for managing TRD.
Study at a glance
| Design | pilot study |
|---|---|
| Sample size | 10 |
| Population | adult patients with treatment resistant depression |
| Key finding | Patients experienced a significant reduction in TRD symptoms, with a decrease in mean PHQ9 score from 17.9 to 9.5. |
Abstract
Background: Treatment resistant depression (TRD) is defined as a major depressive episode that does not improve in response to at least two trials, each of a different class, of antidepressant medication. Pharmacotherapy of TRD with low dose ketamines has been shown as relatively successful in recent studies. Effects of such pharmacotherapy can be augmented by combining ketamine with psychotherapeutic interventions such as Zdyb’s Therapeutic Reset of Internal Processes (TRIP) protocol. Method: 10 adult TRD patients (4 men, 6 women) were treated with low dose ketamines and were also receiving psychotherapeutic intervention as per TRIP protocol. All patients were administered the Patient Health Questionnaire, module 9 (PHQ9) which is a measure of a major depressive episode. The PHQ9 was administered twice: on baseline (i.e., prior to treatment) and after the treatment. Results: On average, our patients fell in the moderate range of severity with respect to symptoms of TRD at baseline (pre-TRIP) as by their mean PHQ9 score of 17.9, (SD = 5.1). Their mean PHQ9 score decreased post TRIP treatment to 9.5 (SD = 6.6): the difference is significant in a t-test, t(10) = 4.3172, p = 0002 (two-tailed). The magnitude of the decrease amounts to 46.9% of the average baseline score. Discussion and Conclusions: Our patients experienced significant reductions in symptoms of TRD in this pilot study. Research studies are now needed with control groups of TRD patients on a waiting list or also of those receiving only the ketamine pharmacotherapy.