Predictive value of heart rate in treatment of major depression with ketamine in two controlled trials
Torsten M. Meyer, Martin Brunovský, Jiřı́ Horáček, Tomáš Novák, Veronika Andrashko, Erich Seifritz, Sebastian Olbrich
Clinical Neurophysiology March 14, 2021 DOI: 10.1016/j.clinph.2021.01.030 via OpenAlex
Summary
AI-generated from the abstractIn patients with major depressive disorder, heart rate and heart rate variability measured before and during ketamine infusion can predict who will respond to treatment. Among 51 patients, those who responded to ketamine had a higher heart rate throughout the study, including at baseline, compared to non-responders. Ketamine infusion increased both heart rate and heart rate variability power during and after infusion. Heart rate and heart rate variability power, but not normalized frequency bands, discriminated between responders and non-responders. These findings suggest that autonomic nervous system markers may help optimize treatment selection for major depressive disorder.
Study at a glance
| Characteristics | Controlled study Peer reviewed |
|---|---|
| Sample size | 51 |
| Population | Patients with major depressive disorder |
| Intervention | Ketamine infusion |
| Duration | 24 hours post infusion, with response assessed within 7 days |
| Topics | Depression Ketamine |
| Keywords | Heart rate variability Depression economics Predictive value |
| Citations | 25 |
| Key finding | Heart rate and heart rate variability power have predictive value for ketamine treatment response in major depressive disorder. |
Abstract
OBJECTIVE: Ketamine has been shown to be effective in treatment of episodes of major depressive disorder (MDD). This controlled study aimed to analyse the predictive and discriminative power of heart rate (HR) and heart rate variability (HRV) for ketamine treatment in MDD. METHODS: In 51 patients, HR and HRV were assessed at baseline before and during ketamine infusion and 24 hours post ketamine infusion. Montgomery-Åsberg Depression Rating Scale (MADRS) was used to assess changes of depressive symptoms. A 30% or 50% reduction of symptoms after 24 hours or within 7 days was defined as response. A linear mixed model was used for analysis. RESULTS: Ketamine infusion increased HR and HRV power during and after infusion. Responders to ketamine showed a higher HR during the whole course of investigation, including at baseline with medium effect sizes (Cohen's d = 0.47-0.67). Furthermore, HR and HRV power discriminated between responders and non-responders, while normalized low and high frequencies did not. CONCLUSION: The findings show a predictive value of HR and HRV power for ketamine treatment. This further underlines the importance of the autonomous nervous system (ANS) and its possible malfunctions in MDD. SIGNIFICANCE: The predictive power of HR and HRV markers should be studied in prospective studies. Neurophysiological markers could improve treatment for MDD via optimizing the choice of treatments.