Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth
In a retrospective matched analysis of 52 transitional age youth (18–25) with treatment‑resistant depression, four intravenous ketamine infusions over two weeks produced significant, moderate‑sized reductions in depressive symptoms, suicidality and anxiety (QIDS‑SR16, SI item, GAD‑7). Clinical benefits, safety and tolerability were comparable to a matched general adult sample (30–60), with only mild, transient adverse effects.
Authors
- Roger McIntyre
- Jonathan Rosenblat
- Shokouh Meshkat
Published
Abstract
Background
Ketamine is an emerging treatment for treatment-resistant depression (TRD) associated with rapid and robust improvements in depressive symptoms and suicidality. However, the efficacy and safety of ketamine in transitional age youth (TAY; age 18–25) populations remains understudied.
Methods
In this retrospective analysis, TAY patients ( n = 52) receiving ketamine for TRD were matched for sex, primary diagnosis, baseline depression severity, and treatment resistance with a general adult (GA) sample (age 30–60). Patients received four ketamine infusions over 2 weeks (0.5–0.75 mg/kg over 40 min). The primary outcome was the change in Quick Inventory of Depressive Symptomatology Self-Report 16-item (QIDS-SR16) over time. Secondary outcomes were changes in QIDS-SR16 suicidal ideation (SI) item, anxiety (Generalized Anxiety Disorder 7-item (GAD-7)), and adverse effects (ClinicalTrials.gov: NCT04209296).
Results
A significant main effect of infusions on reduction of total QIDS-SR16 ( p < 0.001), QIDS-SR16 SI ( p < 0.001), and GAD-7 ( p < 0.001) scores was observed in the TAY group with moderate effect sizes, indicative of clinically significant improvements in depression, anxiety, and suicidality. There were no significant differences between TAY and GA groups on these measures over time, suggesting comparable improvements in both groups. Safety and tolerability outcomes were comparable between groups with only mild, transient adverse effects observed.
Conclusion
Ketamine was associated with comparable clinical benefits, safety, and tolerability in a TAY sample as compared to a matched GA TRD sample.
Research Summary of 'Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth'
Introduction
Chisamore and colleagues frame the study within the problem of treatment-resistant depression (TRD), defined here as inadequate response to two or more adequate antidepressant trials, which affects roughly 30% of patients treated with monoaminergic antidepressants and accounts for a disproportionate share of depression-related costs and morbidity. Transitional age youth (TAY; 18–25 years) are highlighted as a distinct group: brain maturation continues into the mid-20s, onset of mood disorders and suicidality is common in this window, and conventional pharmacotherapies raise particular concerns about safety and tolerability in younger populations. The authors note a gap in the literature on intravenous (IV) ketamine for TRD specifically in TAY, despite established evidence for rapid antidepressant and anti-suicidal effects of ketamine in general adult (GA) samples and some adolescent data pooled across age ranges. This retrospective analysis therefore aims to determine whether repeated IV ketamine infusions produce comparable antidepressant, anti‑suicidal, anxiolytic, functional and tolerability effects in TAY patients with TRD compared to a matched GA cohort. The investigators hypothesised that four ketamine infusions over two weeks would show similar clinical benefits and safety in TAY as in GA patients, and set out to examine symptom trajectories and adverse effects in a real‑world outpatient clinic setting.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- Authors
- APA Citation
Chisamore, N., Danayan, K., Rodrigues, N. B., Di Vincenzo, J. D., Meshkat, S., Doyle, Z., Mansur, R., Phan, L., Fancy, F., Chau, E., Tabassum, A., Kratiuk, K., Arekapudi, A., McIntyre, R. S., & Rosenblat, J. D. (2023). Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth. Journal of Psychopharmacology, 37(8), 775-783. https://doi.org/10.1177/02698811231171531
References (5)
Papers cited by this study that are also in Blossom
Alnefeesi, Y., Chen-Li, D., Jawad, M. Y. et al. · Journal of Psychiatric Research (2022)
Mcintyre, R. S., Rosenblat, J. D., Nemeroff, C. B. et al. · American Journal of Psychiatry (2021)
Serafini, G., Howland, R. H., Rovedi, F. et al. · Current Neuropharmacology (2014)
Singh, J. B., Fedgchin, M., Daly, E. J. et al. · American Journal of Psychiatry (2016)
Wilkinson, S. T., Ballard, E. D., Bloch, M. H. et al. · American Journal of Psychiatry (2017)
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