Trial PaperTreatment-Resistant Depression (TRD)Bipolar DisorderDepressive DisordersKetamine

Plasma BDNF concentrations and the antidepressant effects of six ketamine infusions in unipolar and bipolar depression

This open-label study (n=94) finds that baseline plasma BDNF concentrations (a protein related to nerve growth) correlate with ketamine (6 infusions, 35mg/70kg) antidepressant effects (MADRS).

Authors

  • Yuping Ning
  • Wei Zheng

Published

PeerJ
individual Study

Abstract

Objectives

Accumulating evidence has implicated that brain derived neurotrophic factor (BDNF) is thought to be involved in the pathophysiology of depression, but its correlation with ketamine’s antidepressant efficacy focusing on Chinese individuals with depression is not known. This study was aim to determine the correlation of plasma BDNF (pBDNF) concentrations and ketamine’s antidepressant efficacy.

Methods

Ninety-four individuals with depression received six intravenous infusions ketamine (0.5 mg/kg). Remission and response were defined as Montgomery-Asberg Depression Rating Scale (MADRS) scores less than 10 and a reduction of 50% or more in MADRS scores, respectively. Plasma was collected at baseline and at 24 h and 2 weeks after completing six ketamine infusions (baseline, 13 d and 26 d).

Results

A significant improvement in MADRS scores and pBDNF concentrations was found after completing six ketamine infusions compared to baseline (all ps < 0.05). Higher baseline pBDNF concentrations were found in ketamine responders/remitters (11.0 ± 6.2/10.1 ± 5.8 ng/ml) than nonresponders/nonremitters (8.0 ± 5.5/9.2 ± 6.4 ng/ml) (all ps < 0.05). Baseline pBDNF concentrations were correlated with MADRS scores at 13 d (t = − 2.011, p = 0.047) or 26 d (t = − 2.398, p = 0.019) in depressed patients (all ps < 0.05). Subgroup analyses found similar results in individuals suffering from treatment refractory depression.

Conclusion

This preliminary study suggests that baseline pBDNF concentrations appeared to be correlated with ketamine’s antidepressant efficacy in Chinese patients with depression.

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Research Summary of 'Plasma BDNF concentrations and the antidepressant effects of six ketamine infusions in unipolar and bipolar depression'

Introduction

Accumulating evidence links glutamatergic dysfunction to the pathophysiology of mood disorders, and subanesthetic doses of the NMDA (N-methyl-D-aspartate) receptor antagonist ketamine have been reported to produce rapid antidepressant and antisuicidal effects in unipolar and bipolar depression. Neurotrophic mechanisms, particularly brain-derived neurotrophic factor (BDNF), have been implicated in depression and in antidepressant treatment responses: lower peripheral BDNF levels have been observed in depressed patients versus healthy controls and have risen after successful treatments. Prior studies examining the relationship between peripheral BDNF and ketamine's antidepressant efficacy have produced inconsistent results, and most have considered single infusions rather than repeated administrations; no published work had examined this question in a Chinese sample receiving serial ketamine infusions. Zheng and colleagues designed the present study to test whether six subanesthetic intravenous ketamine infusions (0.5 mg/kg, administered three times weekly over two weeks) change plasma BDNF (pBDNF) concentrations, and whether baseline pBDNF is associated with subsequent antidepressant response. The investigators hypothesised that serial ketamine would increase pBDNF and that higher baseline pBDNF would be associated with better antidepressant outcomes in individuals with unipolar or bipolar depression.

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Study Details

References (3)

Papers cited by this study that are also in Blossom

Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

Rong, C., Park, C., Rosenblat, J. D. et al. · International Journal of Environmental Research and Public Health (2018)

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