Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression

James W. Murrough*, Andrew M. Perez, Sarah Pillemer, Jessica Stern, Michael K. Parides, Marije aan het Rot, Katherine A. Collins, Sanjay J. Mathew, Dennis S. Charney, Dan V. Iosifescu

*Bijbehorende auteur voor dit werk

Onderzoeksoutput: ArticleAcademicpeer review

454 Citaten (Scopus)

Samenvatting

Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine infusions resulted in a sustained antidepressant effect. In the current report, we examined the pattern and durability of antidepressant effects of repeated ketamine infusions in a larger sample, inclusive of the original.

Methods: Participants with TRD (n = 24) underwent a washout of antidepressant medication followed by a series of up to six IV infusions of ketamine (.5 mg/kg) administered open-label three times weekly over a 12-day period. Participants meeting response criteria were monitored for relapse for up to 83 days from the last infusion.

Results: The overall response rate at study end was 70.8%. There was a large mean decrease in Montgomery-Asberg Depression Rating Scale score at 2 hours after the first ketamine infusion (18.9 +/- 6.6, p <.001), and this decrease was largely sustained for the duration of the infusion period. Response at study end was strongly predicted by response at 4 hours (94% sensitive, 71% specific). Among responders, median time to relapse after the last ketamine infusion was 18 days.

Conclusions: Ketamine was associated with a rapid antidepressant effect in TRD that was predictive of a sustained effect. Future controlled studies will be required to identify strategies to maintain an antidepressant response among patients who benefit from a course of ketamine.

Originele taal-2English
Pagina's (van-tot)250-256
Aantal pagina's7
TijdschriftBiological Psychiatry
Volume74
Nummer van het tijdschrift4
DOI's
StatusPublished - 15-aug-2013

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