Effects of low-dose ketamine infusion on vascular endothelial growth factor and matrix metalloproteinase-9 among patients with treatment-resistant depression and suicidal ideation.
Mu-Hong Chen, Wei-Chen Lin, Cheng-Ta Li, Hui-Ju Wu, Ya-Mei Bai, S. Tsai, T. Su, P. Tu
Journal of Psychiatric Research July 1, 2023 DOI: 10.1016/j.jpsychires.2023.07.022 via Semantic Scholar
Summary
In patients with treatment-resistant depression and strong suicidal thoughts, a single low-dose infusion of ketamine did not change blood levels of two proteins—VEGF and MMP-9—compared to a control drug, midazolam. However, patients who had higher VEGF levels before treatment showed greater improvements in depression and suicidal ideation after ketamine. This suggests that baseline VEGF might help predict who will benefit from ketamine, but the drug itself does not alter these protein levels.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 48 |
| Population | Patients with treatment-resistant depression and strong suicidal ideation |
| Keywords | Medicine Psychology |
| Citations | 8 |
| Key finding | A single low-dose ketamine infusion did not alter VEGF or MMP-9 levels, but higher baseline VEGF levels were associated with greater antidepressant and antisuicidal effects. |
Abstract
BACKGROUND Evidence indicates that vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) influence the pathophysiology of depression. However, whether low-dose ketamine regulates VEGF and MMP-9 levels and whether changes in VEGF and MMP-9 levels are associated with the antidepressant and antisuicidal effects of ketamine remained unclear. METHODS Forty-eight patients with treatment-resistant depression and strong suicidal ideation (TRD-SI) were randomly assigned to a single infusion of 0.5-mg/kg ketamine or 0.045-mg/kg midazolam. The Montgomery-Åsberg Depression Rating Scale (MADRS) and Columbia-Suicide Severity Rating Scale-Ideation Severity Subscale (CSSRS-ISS) were used at baseline and subsequently at several postinfusion timepoints. VEGF and MMP-9 serum levels were analyzed at baseline and on day 3 postinfusion. RESULTS After adjustment for baseline levels, no significant differences in VEGF (p = .912) and MMP-9 (p = .758) levels were identified on day 3 postinfusion between the study groups. Baseline VEGF levels but not MMP-9 levels were negatively associated with MADRS and CSSRS-ISS scores following infusion. DISCUSSION A single infusion of low-dose ketamine did not alter the VEGF and MMP-9 levels of the patients with TRD-SI. Higher baseline VEGF levels were associated with greater antidepressant and antisuicidal effects of single low-dose ketamine infusion.