Molecular Psychiatry
October 3, 2018
M. Fava, M. Freeman, M. Flynn et al.
438 citations
Intravenous ketamine at 0.5 mg/kg and 1.0 mg/kg produces rapid antidepressant effects in adults with treatment-resistant depression, with most improvement seen one day after a single 40-minute infusion. Lower doses (0.1 mg/kg and 0.2 mg/kg) did not show consistent benefit. The study compared four ketamine doses against an active placebo (midazolam) in 99 outpatients across six U.S. sites. Higher doses caused more dissociative symptoms and temporary blood pressure increases, but infusions were generally well tolerated. The findings indicate a range of effective subanesthetic doses, with no clear advantage for doses below 0.5 mg/kg.
Journal of Affective Disorders
January 1, 2019
D. Ionescu, Kate H Bentley, M. Eikermann et al.
179 citations
Repeated doses of ketamine did not reduce depression or suicidal ideation more than placebo in outpatients with severe, treatment-resistant depression and chronic suicidal thoughts. Twenty-six medicated adults received six infusions of ketamine or saline over three weeks. Neither depression severity nor suicidal ideation differed between groups during the infusion phase. At three months, two patients in each group had remitted from depression. The authors suggest that the standard 0.5 mg/kg dose may be insufficient for this severely ill outpatient population.
European Neuropsychopharmacology
June 2, 2021
A. Feeney, R. Hock, Marlene P. Freeman et al.
33 citations
A single intravenous infusion of ketamine may reduce suicidal ideation in patients with treatment-resistant depression for up to 30 days, but early effects diminish rapidly. In a double-blind randomized trial, 40 patients received ketamine and 16 received midazolam placebo; all had clinically significant suicidal ideation at baseline. By day 30, the ketamine group had a lower mean suicide score (2.03) than the placebo group (3.00). However, among those whose suicidal ideation initially resolved by day 3, there was no significant difference between groups in later scores. Recurrence of suicidal ideation was common in both groups. The findings suggest a possible role for ketamine as an adjunct to standard treatments.
Journal of Clinical Psychiatry
May 30, 2022
D. Iosifescu, A. Jones, C. O'gorman et al.
In a six-week phase 3 trial, the combination drug dextromethorphan-bupropion (AXS-05) reduced depressive symptoms more than placebo in adults with major depressive disorder. Those taking the drug showed an average 15.9-point drop on the Montgomery-Asberg Depression Rating Scale versus a 12.0-point drop with placebo, a statistically significant difference. Benefits appeared as early as one week. At six weeks, 39.5% of the drug group achieved remission compared to 17.3% of the placebo group, and 54.0% had a clinical response versus 34.0%. Common side effects included dizziness, nausea, and headache. The drug was not linked to weight gain or sexual dysfunction.