The Journal of Clinical Psychiatry
July 23, 2018
Samuel T. Wilkinson, Rachel B. Katz, Mesut Toprak et al.
88 citations
In a clinical setting, ketamine infusions for severe, treatment-resistant mood disorders showed lower response and remission rates than those in research protocols. Of 44 patients starting a four-infusion protocol, 45.5% responded and 27.3% remitted by the fourth infusion. A small long-term subsample (n=14) received 12 to 45 total treatments over 14 to 126 weeks with no observed cognitive decline, increased delusions, or cystitis symptoms. The treatment was generally well tolerated, but the small maintenance group limits conclusions about long-term safety.
JAMA Psychiatry
May 11, 2022
Sina Nikayin, Taeho Greg Rhee, Maria Elena Cunningham et al.
43 citations
In a clinical setting, patients treated with intravenous ketamine or intranasal esketamine showed similar trajectories of depression severity over time, suggesting both treatments are comparably effective for depression.
JAMA network open
June 3, 2024
Manish Kumar Jha, Samuel T Wilkinson, Kamini Krishnan et al.
29 citations
In people with treatment-resistant depression who do not have psychosis, intravenous ketamine works as well as electroconvulsive therapy (ECT) overall. Among outpatients with moderately severe or severe depression, ketamine produced greater improvement in depressive symptoms than ECT. In contrast, inpatients with very severe depression improved more with ECT early in treatment, though by the end of the three-week course both treatments were similarly effective. Higher premorbid intelligence and a diagnosis of posttraumatic stress disorder were linked to greater improvement with ECT, but not with ketamine. These findings may help patients and clinicians decide between the two treatments.
General hospital psychiatry
January 1, 2024
Mina Ansari, Brian Pittman, Daniel S Tylee et al.
6 citations
Blood pressure increases during ketamine infusion for depression, peaking at 40 minutes with average rises of 16.0 mmHg systolic and 11.0 mmHg diastolic. Severe hypertension occurred in 12.5% of patients and 0.98% of infusion sessions, most often during the first three treatments. Older age and a history of hypertension were associated with larger blood pressure surges, indicating that careful cardiovascular monitoring is needed, especially for these patients.