Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth
Noah Chisamore, Kevork Danayan, Nelson B Rodrigues, Joshua D. Di Vincenzo, Shakila Meshkat, Zoe Doyle, R. Mansur, Lee Phan, Farhan Fancy, E. Chau, Aniqa Tabassum, Kevin Kratiuk, Anil Arekapudi, R. Mcintyre, J. Rosenblat
Journal of Psychopharmacology May 16, 2023 DOI: 10.1177/02698811231171531 via Semantic Scholar
Summary
Ketamine infusions led to clinically significant reductions in depression, anxiety, and suicidal thoughts in transitional age youth (ages 18–25) with treatment-resistant depression. In a retrospective analysis of 52 youth matched with a general adult sample (ages 30–60), both groups showed comparable improvements after four infusions over two weeks, with moderate effect sizes and no significant group differences. Adverse effects were mild and transient. The findings suggest ketamine is similarly effective and safe for younger adults as for older adults with treatment-resistant depression.
Study at a glance
| Characteristics | Retrospective analysis Peer reviewed |
|---|---|
| Sample size | 52 |
| Population | Transitional age youth (age 18–25) with treatment-resistant depression |
| Keywords | Medicine Psychology |
| Citations | 13 |
| Registration | NCT04209296 |
| Key finding | Ketamine produced comparable improvements in depression, anxiety, and suicidality in transitional age youth and general adults with treatment-resistant depression, with similar safety and tolerability. |
Abstract
Background: Ketamine is an emerging treatment for treatment-resistant depression (TRD) associated with rapid and robust improvements in depressive symptoms and suicidality. However, the efficacy and safety of ketamine in transitional age youth (TAY; age 18–25) populations remains understudied. Methods: In this retrospective analysis, TAY patients (n = 52) receiving ketamine for TRD were matched for sex, primary diagnosis, baseline depression severity, and treatment resistance with a general adult (GA) sample (age 30–60). Patients received four ketamine infusions over 2 weeks (0.5–0.75 mg/kg over 40 min). The primary outcome was the change in Quick Inventory of Depressive Symptomatology Self-Report 16-item (QIDS-SR16) over time. Secondary outcomes were changes in QIDS-SR16 suicidal ideation (SI) item, anxiety (Generalized Anxiety Disorder 7-item (GAD-7)), and adverse effects (ClinicalTrials.gov: NCT04209296). Results: A significant main effect of infusions on reduction of total QIDS-SR16 (p < 0.001), QIDS-SR16 SI (p < 0.001), and GAD-7 (p < 0.001) scores was observed in the TAY group with moderate effect sizes, indicative of clinically significant improvements in depression, anxiety, and suicidality. There were no significant differences between TAY and GA groups on these measures over time, suggesting comparable improvements in both groups. Safety and tolerability outcomes were comparable between groups with only mild, transient adverse effects observed. Conclusion: Ketamine was associated with comparable clinical benefits, safety, and tolerability in a TAY sample as compared to a matched GA TRD sample.