At-home ketamine-assisted therapy with remote monitoring produced rapid and significant improvements in depression and anxiety. Among 1247 patients, 62.8% showed at least 50% improvement on the depression scale and 62.9% on the anxiety scale, with remission rates of 32.6% and 31.3%, respectively. Deterioration was rare (0.9% for depression, 0.6% for anxiety). Three patient subpopulations emerged: those who improved steadily (79.3%), those with delayed improvement (9.3%), and a chronic group (11.4%) who were more likely to report dissociation at the fourth session. Side effects at the second session predicted delayed improvement. Only six patients discontinued early due to side effects or adverse events, indicating that screening and monitoring kept risks low.
In a large longitudinal study of 11,441 moderately-to-severely depressed patients who received four doses of sublingual ketamine at home over four weeks within a supportive digital health context, treatment was associated with improvement in depression symptoms. A modal antidepressant response occurred in both non-severe (55.8%) and severe (18.1%) baseline depression levels. Adverse events were detected in 3.0-4.8% of participants, predominantly neurologic or psychiatric. A second course of treatment extended improvements in those who responded favorably. Improvement was most strongly predicted by lower baseline depression scores and younger age. Symptoms of depressed mood and anhedonia persisted despite treatment. The study lacked a control group and fixed-dose procedure. At-home, telehealth-supported ketamine administration was largely safe, well-tolerated, and associated with improvement.