Ketamine Infusion (KI) in Treatment Resistant Depression (TRD): Retrospective Clinical Data Analysis
Open Access
- 1 January 2019
- journal article
- research article
- Published by Scientific Research Publishing, Inc. in Open Journal of Depression
- Vol. 08 (03), 59-70
- https://doi.org/10.4236/ojd.2019.83007
Abstract
Objective: The aim of this paper is to present the clinical data analysis results from a service delivering ketamine infusion, repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy for people with treatment resistant depression (TRD). Methods: The study was a retrospective investigation of routinely collected data on patients receiving ketamine infusion between 2017 and 2019. Measures used were the clinician-rated Clinical Global Impression (CGI) and self-reported Beck Depression Inventory (BDI) and Quick Inventory of Depressive Symptomatology (QIDS-SR). The outcome data of 28 patients with TRD were analysed. A minimum course of treatment was defined as three ketamine infusions. Results: Response combined with partial response, response, and remission rates respectively were 42.3%, 23.1% and 4.2% for the BDI; 18.2%, 9.1% and 0% for the QIDS-SR; 50%, 18.2% and 4.6% for the CGI. There was a statistically significant improvement on the BDI with a medium effect size (0.63). There was not a significant improvement in the CGI or QIDS-SR. Conclusions: The results show a mixed picture the impact ketamine on symptoms of depression in TRD over the course of multiple infusions. The results need to be viewed in the context of clinical outcome data collection: outcome scores are taken prior to treatment and so are at a point when ketamine is not having an active effect. The findings can inform the availability of ketamine infusion as a treatment option for TRD where treatment adhering to national guidelines has not succeeded. A qualitative investigation of the experience of people receiving ketamine would provide further insights.Keywords
This publication has 40 references indexed in Scilit:
- Towards a glutamate hypothesis of depression: An emerging frontier of neuropsychopharmacology for mood disordersNeuropharmacology, 2012
- The clinical global impression scale and the influence of patient or staff perspective on outcomeBMC Psychiatry, 2011
- Response and remission criteria in major depression – A validation of current practiceJournal of Psychiatric Research, 2010
- Clinical Outcomes and Quality of Life in Patients Submitted to Electroconvulsive TherapyThe Journal of ECT, 2009
- Regional Cerebral Blood Flow Changes after Low-Frequency Transcranial Magnetic Stimulation of the Right Dorsolateral Prefrontal Cortex in Treatment-Resistant DepressionNeuropsychobiology, 2008
- The Burden of Mental DisordersEpidemiologic Reviews, 2008
- What is the meaning of treatment resistant/refractory major depression (TRD)? A systematic review of current randomized trialsEuropean Neuropsychopharmacology, 2007
- Stress, Depression, and Neuroplasticity: A Convergence of MechanismsNeuropsychopharmacology, 2007
- Clinical Factors Associated With Treatment Resistance in Major Depressive DisorderBritish Journal of Psychology, 2007
- Ketamine Increases Human Motor Cortex Excitability to Transcranial Magnetic StimulationJournal Of Physiology-London, 2003