Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
2 papers in the library · 7 citations · publishing 2024-2025
Non-improvement after four ketamine infusions, or three consecutive non-improvements after three infusions, reliably predicts overall non-response to a six-dose course of intravenous ketamine for depression. Among 135 individuals with major depressive or bipolar disorder in a current depressive episode, sensitivities for predicting non-response exceeded 90% using these early non-improvement criteria. Those who did not improve by these points showed no significant reduction in depressive symptoms from subsequent infusions. The findings suggest that early non-improvement can guide clinicians to discontinue treatment, avoiding ineffective continued dosing.
Ketamine improves depressive symptoms in major depressive disorder by altering energy metabolism, including changes in adenosine triphosphate, adenosine diphosphate (ADP), and pyruvate. The shift in ADP levels strongly correlated with reductions in depression severity scores. Lower baseline levels of free triiodothyronine (FT3) predicted a better response to ketamine, suggesting FT3 may serve as a biological marker for treatment efficacy. These findings come from a study of 40 patients in a discovery cohort and 24 in a validation cohort, using metabolomic analysis of serum samples.