Does body mass index predict response to intravenous ketamine treatment in adults with major depressive and bipolar disorder? Results from the Canadian Rapid Treatment Center of Excellence
Orly Lipsitz, Roger S. McIntyre, Nelson B. Rodrigues, Yena Lee, Hartej Gill, Mehala Subramaniapillai, Kevin Kratiuk, Flora Nasri, Rodrigo B. Mansur, Joshua D. Rosenblat
CNS Spectrums December 3, 2020 DOI: 10.1017/s1092852920002102 via OpenAlex
Summary
AI-generated from the abstractHigher body mass index (BMI) does not predict how well patients with treatment-resistant depression respond to intravenous (IV) ketamine. In a study of 230 adults who received four ketamine infusions, people with normal weight, overweight, and obesity (classes I and II) showed similar improvements in depression, suicidal thoughts, anxiety, anhedonia, and daily functioning. The antidepressant effects and rates of partial response, response, and remission were comparable across all BMI groups. The findings are limited by the observational, open-label design of this retrospective analysis.
Study at a glance
| Characteristics | Retrospective analysis Open-label Peer reviewed |
|---|---|
| Sample size | 230 |
| Population | Adults with treatment-resistant depression |
| Intervention | Intravenous ketamine |
| Duration | Four infusions |
| Topics | Anxiety Depression Ketamine |
| Keywords | Body mass index Overweight Bipolar disorder Depression economics |
| Citations | 25 |
| Key finding | Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI. |
Abstract
BACKGROUND: Higher body mass index (BMI) has been found to predict greater antidepressant response to intravenous (IV) ketamine treatment. We evaluated the association between BMI and response to repeat-dose IV ketamine in patients with treatment-resistant depression (TRD). METHODS: Adults (N = 230) with TRD received four infusions of IV ketamine at a community-based clinic. Changes in symptoms of depression (ie, Quick Inventory for Depressive Symptomatology-Self-Report 16; QIDS-SR16), suicidal ideation (SI; ie, QIDS-SR16 SI item), anxiety (ie, Generalized Anxiety Disorder-7 Scale), anhedonic severity (ie, Snaith-Hamilton Pleasure Scale), and functioning (ie, Sheehan Disability Scale) following infusions were evaluated. Participants were stratified by BMI as normal (18.0-24.9 kg/m2; n = 72), overweight (25-29.9 kg/m2; n = 76), obese I (30-34.9 kg/m2; n = 47), or obese II (≥35.0 kg/m2; n = 35). RESULTS: Similar antidepressant effects with repeat-dose ketamine were reported between BMI groups (P = .261). In addition, categorical partial response (P = .149), response (P = .526), and remission (P = .232) rates were similar between the four BMI groups. CONCLUSIONS: The findings are limited by the observational, open-label design of this retrospective analysis. Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI.