IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital
This longitudinal study (n=71) examines five years of real-world clinical data on the use of IV low-dose ketamine alongside standard care for outpatients with depression (MDD & TRD). Results indicate a significant reduction in depressive symptoms and suicide ideation by treatment endpoint, with 55% of patients responding to treatment. Side effects were transient and mild for 78% of patients, with a dropout rate of 11%. Multivariate analysis suggests that demographic variables did not impact treatment efficacy or tolerability.
Authors
- Gutierrez, G.
- Kang, M. J. Y.
- Vasquez, G.
Published
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.
Research Summary of 'IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital'
Introduction
Depression is a leading cause of global disability and a substantial proportion of patients do not remit with standard antidepressant treatments; about one-third are considered to have treatment resistant depression (TRD). Intravenous low dose ketamine has emerged as a promising option because sub‑anaesthetic doses have demonstrated rapid and potent antidepressant effects, including reductions in suicide ideation (SI). Professional guidance such as CANMAT recommendations and recent systematic reviews support ketamine's effectiveness, yet the existing evidence base is limited by inconsistent TRD definitions, scarce long‑term safety and tolerability data, uncertain misuse potential, and a predominance of controlled trial settings rather than naturalistic clinical practice. Gutierrez and colleagues set out to add real‑world evidence by retrospectively analysing five years of clinical data from a tertiary outpatient mood disorders clinic that has provided IV low dose ketamine as standard care. The study aimed to evaluate the treatment's effectiveness on depressive symptoms and SI, to describe tolerability and side effects in routine practice, and to determine whether sociodemographic variables influenced outcomes. Their hypothesis was that IV low dose ketamine would be effective and tolerable for patients with major depressive disorder and TRD treated at their clinic.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- APA Citation
Gutierrez, G., Kang, M. J., & Vazquez, G. (2024). IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital. Psychiatry Research, 335, 115865. https://doi.org/10.1016/j.psychres.2024.115865
References (8)
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Jesus‐Nunes, A. P., Leal, G. C., Correia‐Melo, F. S. et al. · Human Psychopharmacology (2022)
Mcintyre, R. S., Rosenblat, J. D., Nemeroff, C. B. et al. · American Journal of Psychiatry (2021)
Short, B., Fong, J., Galvez, V. et al. · Lancet Psychiatry (2017)
Siegel, A. N., Di, J. D., Brietzke, E. et al. · Journal of Psychiatric Research (2021)
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Yonezawa, K., Uchida, H., Yatomi, T. et al. · Pharmacopsychiatry (2023)
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