Treatment-emergent symptoms during short-term ketamine administration in treatment-resistant bipolar depression: A retrospective cross-sectional descriptive study.
Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny
Asian journal of psychiatry September 1, 2024 DOI: 10.1016/j.ajp.2024.104159 via PubMed
Summary
AI-generated from the abstractIn patients with treatment-resistant bipolar depression receiving eight intravenous ketamine infusions while continuing their usual medications, the most common new symptoms that appeared included decreased appetite, weight gain, excessive sleep, and mood changes that varied throughout the day. Feelings of sadness, hopelessness about the future, reduced sexual interest, and physical discomfort did not emerge. However, 13.6% of patients reported new thoughts of death or suicide. Larger studies using both clinician and patient reports are needed to better understand these treatment-emergent symptoms, and clearer definitions would improve future research.
Study at a glance
| Characteristics | Observational study Cross-sectional Peer reviewed |
|---|---|
| Population | Treatment-resistant bipolar depression patients |
| Intervention | intravenous ketamine infusions |
| Duration | Eight intravenous ketamine infusions |
| Topics | Ketamine |
| Keywords | Bipolar depression Bipolar disorder Treatment-emergent symptoms Ketamine therapy Bipolar treatment |
| Citations | 8 |
| Key finding | 13.6% of patients reported new thoughts of death or suicide after eight intravenous ketamine infusions, while other common emergent symptoms included decreased appetite, increased weight, hypersomnia, and diurnal mood variation. |
Abstract
Symptoms that emerge during pharmacological treatment of bipolar depression are frequently observed, underscoring the necessity for comprehensive treatment monitoring. This observational study sought to observe the correlation of eight intravenous ketamine infusions with treatment-emergent depressive symptoms in treatment-resistant bipolar depression patients who maintained their baseline psychotropic and chronic somatic treatments. Depressive symptoms were evaluated using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Treatment-emergent symptoms TES were defined as symptoms absent at baseline but present at the conclusion of the study. The most common TES included decreased appetite, increased weight, hypersomnia, and diurnal mood variation. Conversely, feelings of sadness, altered perceptions of the future, decreased interest in sex, and physical discomfort were absent in all patients. Notably, 13.6 % of patients reported thoughts of death or suicide. Larger-scale studies, integrating clinician-rated and patient-reported outcome measures, are essential to deepen our understanding of treatment-emergent symptoms. Establishing regulatory or professional definitions for treatment-emergent symptoms is warranted to improve the robustness of future research endeavors.