Wednesday, August 28, 2013

Ketamine May Be Beneficial in Treatment-Resistant Depression, Study Finds

Pursuing effective therapies to alleviate treatment-resistant depression can be challenging for both patient and clinician, but a study published today in AJP in Advance may offer some hope to those who have not responded to a standard depression treatments.

Researchers at the Michael E. Debakey VA Medical Center, Baylor College of Medicine, and Icahn School of Medicine at Mount Sinai investigated the rapid antidepressant efficacy of the FDA-approved anesthetic drug—ketamine. It was the largest ketamine study to date and first to compare ketamine with a psychoactive control, according to Sanjay Mathew,M.D., corresponding author and psychopharmacology chair of Baylor’s Mood Disorder Program.

Seventy-three patients with treatment-resistant depression were divided into two groups: those receiving a single intravenous dose of ketamine and those receiving the active placebo, midazolam. Results showed that within 24 hours, drug response rate for the ketamine group was 64%, compared with 28% in midazolam group. Though drug response rates did not differ between the groups after seven days of drug infusion, 45% of individuals in the ketamine group reported fewer depressive symptoms. Ketamine did raise concerns, including the drug’s likelihood to increase blood pressure by 20 points within an hour following administration.

Mathew told Psychiatric News, “The results from this study are still preliminary.... The goal of future research is to find out ways to prolong benefits beyond the acute phase. We are investigating repeated infusions as one option, [and]larger studies, which seek to optimize dose, are in the planning stages.” The study was funded by the National Institute of Mental Health, the Brain & Behavior Research Foundation, the Brown Foundation, and the National Center for Advancing Translational Sciences.

For more research on the use of ketamine in psychiatric illness, see the Psychiatric News article "Bipolar-Depression Improvement Follows Ketamine Infusion." 

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