Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic.

In a private ketamine clinic in South Africa, adding intravenous ketamine to usual treatment for depression was associated with reduced depression severity and suicidal ideation. Among 154 patients who received ketamine infusions, 67 completed a six-infusion initial series; 60.6% responded (a more than 50% decrease in PHQ-9 score) and 32.4% achieved remission. Half of all 154 patients no longer reported suicidal ideation after treatment. Adverse events requiring intervention occurred in 6.2% of infusions, mostly nausea. Of those who completed the initial series, 48.5% continued maintenance infusions with no evidence of escalating use or abuse. This retrospective chart review is the first naturalistic study on ketamine for depressive symptoms in South Africa.

Study at a glance

Abstract

There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses of ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting in South Africa. This retrospective chart review reports the clinical response (change in Patient Health Questionnaire - 7 score) to an initial infusion series of ketamine added to usual treatment, and the pattern of its subsequent maintenance use, for depressive symptoms. A private ketamine clinic in Hilton, KwaZulu-Natal. The medical records of all patients who attended a private ketamine clinic between August 2019 and 31 May 2021 were retrospectively analysed. Depression symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9) administered immediately before and 24 h after each treatment. Response was defined as a score decrease of more than 50%. Among the 154 patients who received ketamine infusions for depression, 67 completed a six infusion initial series, with a response rate of 60.6% and remission rate of 32.4%. Of the 154, 50% no longer experienced any suicidal ideation after treatment and adverse events were uncommon, with 6.2% of infusions requiring intervention for adverse events, mostly nausea. In addition, 48.5% of those who completed the initial series continued to receive maintenance infusions, with no evidence of escalating use or abuse. Incorporating intravenous ketamine into the existing treatment regimens at a private clinic was associated with reduced acuteness of depression severity and suicidal ideation. This approach appeared safe and tolerable, showing no signs of abuse or dependence. This is the first known naturalistic study reporting on ketamine use for depressive symptoms in South Africa.