Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder.
Kevork Danayan, Noah Chisamore, Nelson B Rodrigues, J. D. Vincenzo, Shakila Meshkat, Zoe Doyle, R. Mansur, Lee Phan, Farhan Fancy, E. Chau, Aniqa Tabassum, Kevin Kratiuk, Anil Arekapudi, K. Teopiz, R. Mcintyre, J. Rosenblat
Psychiatry Research March 5, 2023 DOI: 10.1016/j.psychres.2023.115133 via Semantic Scholar
Summary
Intravenous ketamine reduced symptoms of depression, borderline personality, suicidality, and anxiety in people with treatment-resistant depression and comorbid borderline personality disorder. In a retrospective analysis of 100 participants, those with borderline personality disorder showed significant improvement, with a reduction of 5.95 points on the Quick Inventory of Depressive Symptomatology and a reduction of 0.64 on the Borderline Symptom List. Both groups with and without borderline personality disorder improved similarly on depression, anxiety, and functionality measures, with no significant difference between groups.
Study at a glance
| Characteristics | Retrospective analysis Peer reviewed |
|---|---|
| Sample size | 100 |
| Population | Adults with treatment-resistant depression, with or without comorbid borderline personality disorder, receiving care at a Canadian rapid treatment centre |
| Keywords | Medicine Psychology |
| Citations | 36 |
| Registration | NCT04209296 |
| Key finding | Intravenous ketamine significantly reduced depressive and borderline symptoms in patients with treatment-resistant depression and comorbid borderline personality disorder, with no significant difference in improvement between those with and without borderline personality disorder. |
Abstract
Borderline personality disorder (BPD) has high rates of comorbidity with mood disorders, including treatment-resistant depression (TRD). Comorbidity of BPD with depression is associated with poorer response to antidepressants. Intravenous ketamine is a novel treatment for TRD that has not been specifically evaluated in patients with comorbid BPD. In this retrospective analysis of data collected from participants who received care at the Canadian Rapid Treatment Centre of Excellence (CRTCE; Braxia Health; ClinicalTrials.gov: NCT04209296), we evaluated the effectiveness of intravenous ketamine in a TRD population with comorbid BPD (N=100; n=50 BPD-positive compared with n=50 BPD-negative). Participants were administered four doses of intravenous ketamine (0.5-0.75mg/kg over 40 minutes) over two weeks. The primary outcome measures were changes in depressive symptom severity (as measured by Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR16)) and borderline symptom severity (as measured by Borderline Symptom List 23-item (BSL-23)). Both BPD-positive and BPD-negative groups improved significantly on the QIDS-SR16, QIDS-SR16 suicide ideation item, anxiety, and functionality scales with large effect sizes. There was no significant difference between groups. The BPD-positive group exhibited significant reduction of 0.64 on BSL-23 scores and a significant reduction of 5.95 on QIDS-SR16 scores. Patients with TRD and comorbid BPD receiving ketamine exhibited a significant reduction in symptoms of depression, borderline personality, suicidality, and anxiety.