Effectiveness of intravenous ketamine in mood disorder patients with a history of neurostimulation
Nelson B. Rodrigues, Ashley Siegel, Orly Lipsitz, Danielle S. Cha, Hartej Gill, Flora Nasri, Kevin Simonson, Margarita Shekotikhina, Yena Lee, Mehala Subramaniapillai, Kevin Kratiuk, Kangguang Lin, Roger Ho, Rodrigo B. Mansur, Roger S. McIntyre, Joshua D. Rosenblat
CNS Spectrums December 10, 2020 DOI: 10.1017/s1092852920002187 via OpenAlex
Summary
AI-generated from the abstractIntravenous (IV) ketamine effectively reduces symptoms of depression, suicidal ideation, anxiety, and anhedonia in adults with treatment-resistant depression, regardless of whether they have previously undergone neurostimulation. In a retrospective analysis of 238 patients, those without prior neurostimulation experienced an average 6.4-point reduction on a depression severity scale, while those with a history of neurostimulation showed a 4.3-point reduction. No significant differences emerged between the groups, indicating that IV ketamine benefits even highly intractable patients.
Study at a glance
| Characteristics | Retrospective post-hoc analysis Peer reviewed |
|---|---|
| Sample size | 238 |
| Population | Adults with treatment-resistant depression (TRD) from a community-based sample |
| Intervention | Intravenous (IV) ketamine |
| Duration | Four infusions |
| Topics | Anxiety Depression Ketamine |
| Keywords | Anhedonia Neurostimulation Depression economics |
| Citations | 17 |
| Key finding | IV ketamine infusions significantly reduced depression severity, suicidal ideation, anxiety, and anhedonia in both neurostimulation-naïve patients and those with a history of neurostimulation, with no between-group differences. |
Abstract
BACKGROUND: Patients unsuccessfully treated by neurostimulation may represent a highly intractable subgroup of depression. While the efficacy of intravenous (IV) ketamine has been established in patients with treatment-resistant depression (TRD), there is an interest to evaluate its effectiveness in a subpopulation with a history of neurostimulation. METHODS: This retrospective, posthoc analysis compared the effects of four infusions of IV ketamine in 135 (x̄ = 44 ± 15.4 years of age) neurostimulation-naïve patients to 103 (x̄ = 47 ± 13.9 years of age) patients with a history of neurostimulation. The primary outcome evaluated changes in depression severity, measured by the Quick Inventory for Depression Symptomatology-Self Report 16-Item (QIDS-SR16). Secondary outcomes evaluated suicidal ideation (SI), anxiety severity, measured by the Generalized Anxiety Disorder 7-Item (GAD-7), and consummatory anhedonia, measured by the Snaith-Hamilton Pleasure Scale (SHAPS). RESULTS: Following four infusions, both cohorts reported a significant reduction in QIDS-SR16 Total Score (F (4, 648) = 73.4, P < .001), SI (F (4, 642) = 28.6, P < .001), GAD-7 (F (2, 265) = 53.8, P < .001), and SHAPS (F (2, 302) = 45.9, P < .001). No between-group differences emerged. Overall, the neurostimulation-naïve group had a mean reduction in QIDS-SR16 Total Score of 6.4 (standard deviation [SD] = 5.3), whereas the history of neurostimulation patients reported a 4.3 (SD = 5.3) point reduction. CONCLUSION: IV ketamine was effective in reducing symptoms of depression, SI, anxiety, and anhedonia in both cohorts in this large, well-characterized community-based sample of adults with TRD.