IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital

Summary & key facts

Researchers looked at five years of real-world clinic records from a public hospital to see how low-dose intravenous ketamine worked for people whose major depression did not improve with usual treatments. They studied about 70 outpatients, most of them around 50 years old and about three-quarters women. By the end of treatment, depression scores and thoughts of suicide had dropped, about half of patients showed a clear antidepressant response, most had only short-lived mild side effects, and only a small number stopped treatment early. These results suggest ketamine can act quickly and be tolerated in routine care, but this kind of study cannot prove cause the way a tightly controlled trial

Key facts:

• The study used five years of real-world clinic data from a public hospital and included 71 outpatients with treatment-resistant major depression.
• Patients were about 50 years old on average and about three-quarters were female.
• By the end of treatment, researchers found a clear reduction in depressive symptoms and in thoughts of suicide.
• About 55% of patients showed a meaningful response to the ketamine treatment.
• Around 78% of patients experienced mild side effects that were short-lived.
• About 11% of patients dropped out of the treatment before completion.
• Analysis showed that basic demographic factors like age and sex did not change how well the treatment worked or how tolerable it was.

Abstract

Individuals with major depressive disorder and treatment resistant depression (MDD-TRD) have limited and sometimes poorly tolerated therapeutic options. Low dose ketamine has presented promising and potent antidepressant effects in this population. To support the existent literature, we conducted a longitudinal study examining five years of real-world clinical data on the use of IV low-dose ketamine alongside standard care for MDD-TRD outpatients. For this study we collected demographic information, clinical scale scores, side effects and dropout data. The data was analyzed using descriptive statistics, effect size using Cohen's D analysis, and multivariate ANOVA (MANOVA) to determine the impact of sociodemographic variables. 71 outpatients (50.28 years old, SD: 14.26; female 74.65%) were included in the analysis. The results showed a significant reduction in depressive symptoms and suicide ideation (SI) by treatment endpoint. 54.93% of patients responded to the treatment, 78.26% experienced transient and mild side effects, and 11.27% of dropped out of the treatment. Multivariate analysis showed that the demographic variables did not impact treatment effect or tolerability. The results of this study suggest that IV low dose ketamine treatment is effective, fast-acting, and well tolerated for the management of depressive symptoms and SI in patients with MDD-TRD in naturalistic clinical practice.

Topics

Mental Health Research Topics Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Adverse effect Antidepressant Cognition Computer science Depression (economics) Economics Environmental health Hippocampus Internal medicine Ketamine Machine learning Macroeconomics Major depressive disorder Medicine Multivariate analysis of variance Population Psychiatry Tolerability Treatment-resistant depression

Substances

Ketamine

Conditions & symptoms

Depression Lack of energy or motivation Sadness or low mood