In a retrospective chart review of 209 adults with treatment-resistant depression treated with intravenous ketamine, depressive and anxiety symptoms improved significantly over four or six infusions, but the improvements were modest and highly variable across individuals. Anxiety symptoms improved more slowly and less robustly than depressive symptoms. End-of-treatment response and remission rates were numerically higher after six infusions than after four, but the difference was not statistically significant. Four distinct patterns of symptom change emerged for both depression and anxiety, highlighting the heterogeneity of treatment response. Durability after six infusions could not be assessed because follow-up data were available only for the four-infusion group.
Among 914 patients with treatment-resistant depression (TRD) or major depression with suicidal ideation (MDSI), moderate-to-very severe depression affected 36.5% of those with TRD and 48.3% of those with MDSI. Mean work impairment was 26% and overall impairment 34.7%. Most patients reported no-to-mild impairment in basic needs, social functioning, work, quality of life, and general health. Physicians underestimated the daily-life impact and unmet treatment need. Among 94 patients prescribed esketamine, improvements in clinical global impression occurred in 64.6-77.8% and in activities of daily living in 34-67%, indicating favorable outcomes.