Efficacy of addition of the anti-inflammatory, IV glutathione to standard ketamine IV therapy in major depressive disorder.
Ladan Eshkevari, Michelle Sales, Christina Collins, Julia Totoraitis, Lindsay Donohue, Carrie Bowman-Dalley, Bejamin Bregman, Paulo Negro, Stephanie Gordon, Christian Estrada
Psychiatry research July 1, 2024 DOI: 10.1016/j.psychres.2024.115949 via PubMed
Summary
AI-generated from the abstractAdding glutathione, an antioxidant, to standard ketamine infusion does not improve outcomes for people with major depressive disorder compared to ketamine alone. In a double-blind study with 30 patients split into two groups of 15, both groups showed significant drops in depression scores from day 1 to day 14, and from day 14 to day 28 for one measure, indicating the overall treatment was effective. However, there were no statistically significant differences between the groups over time. A sustained improvement in depressive symptoms lasted for 14 days after infusion in both groups.
Study at a glance
| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Patients with major depressive disorder |
| Interventions | Ketamine infusion Glutathione |
| Duration | 28 days |
| Topics | Depression Ketamine Neuroplasticity |
| Keywords | Glutathione Inflammation Oxidative stress |
| Citations | 3 |
| Key finding | Adding glutathione to ketamine infusion did not produce statistically significant differences in depression outcomes compared to ketamine alone, though both groups showed sustained improvement for 14 days. |
Abstract
Ketamine, a N-methyl-D-aspartate (NMDA) antagonist, is used for treatment-resistant depression (TRD). Recent studies have shown that there are increased levels of pro-inflammatory cytokines in individuals with major depressive disorder (MDD) and those with higher levels of oxidative stress markers have a decreased or null response to conventional antidepressants. Glutathione (GSH) as an antioxidant adjuvant to ketamine has not been well studied. This double-blind study with 30 patients divided into 2 groups of 15 each, aimed to determine if GSH, added to standard ketamine infusion (GSH+K), rendered better outcomes in MDD patients versus patients receiving ketamine infusions with a normal saline placebo (K+NS). There were significant drops in BDI-II scores from day 1 to day 14, PHQ- scores from day 1 to day 14 and PHQ-9 scores day 14 to day 28, suggesting the overall treatment was effective. There were no statistically significant differences between the groups over time. However, a sustained improvement in depressive symptoms was observed for 14 days post-infusion in both groups.