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–Åsberg 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.
Key Words
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Article Info
Publication History
Published online: July 30, 2012
Accepted:
June 20,
2012
Received in revised form:
June 13,
2012
Received:
May 3,
2012
Identification
Copyright
© 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
