Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic.
The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa – January 01, 2024
Source: PubMed
Summary
Intravenous ketamine offers new hope for people with major depression, showing remarkable success in a South African clinic. Among 154 patients receiving ketamine infusions alongside their usual treatments, over 60% experienced significant improvement after completing the initial induction series. Half of the patients reported complete relief from suicidal thoughts, while one-third achieved full remission. Many continued with maintenance doses, showing no signs of dependency. Side effects were minimal, mainly limited to manageable nausea.
Abstract
There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses of ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting in South Africa. This retrospective chart review reports the clinical response (change in Patient Health Questionnaire - 7 score) to an initial infusion series of ketamine added to usual treatment, and the pattern of its subsequent maintenance use, for depressive symptoms. A private ketamine clinic in Hilton, KwaZulu-Natal. The medical records of all patients who attended a private ketamine clinic between August 2019 and 31 May 2021 were retrospectively analysed. Depression symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9) administered immediately before and 24 h after each treatment. Response was defined as a score decrease of more than 50%. Among the 154 patients who received ketamine infusions for depression, 67 completed a six infusion initial series, with a response rate of 60.6% and remission rate of 32.4%. Of the 154, 50% no longer experienced any suicidal ideation after treatment and adverse events were uncommon, with 6.2% of infusions requiring intervention for adverse events, mostly nausea. In addition, 48.5% of those who completed the initial series continued to receive maintenance infusions, with no evidence of escalating use or abuse. Incorporating intravenous ketamine into the existing treatment regimens at a private clinic was associated with reduced acuteness of depression severity and suicidal ideation. This approach appeared safe and tolerable, showing no signs of abuse or dependence. This is the first known naturalistic study reporting on ketamine use for depressive symptoms in South Africa.