A Randomized, Double-Blind, Midazolam-Controlled Trial of Low-Dose Ketamine Infusion in Patients With Treatment-Resistant Depression and Prominent Suicidal Ideation

Author:

Su Tung-Ping12345,Li Cheng-Ta241ORCID,Lin Wei-Chen241,Wu Hui-Ju1,Tsai Shih-Jen241ORCID,Bai Ya-Mei241,Mao Wei-Chung5,Tu Pei-Chi231,Chen Li-Fen241,Li Wei-Chi467,Chen Mu-Hong467ORCID

Affiliation:

1. Department of Psychiatry, Taipei Veterans General Hospital , Taipei , Taiwan

2. Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University , Taipei , Taiwan

3. Department of Medical Research, Taipei Veterans General Hospital , Taipei , Taiwan

4. Institute of Brain Science, National Yang Ming Chiao Tung University , Taipei , Taiwan

5. Department of Psychiatry, Cheng Hsin General Hospital , Taipei , Taiwan

6. Institute of Biomedical Informatics, National Yang Ming Chiao Tung University , Taipei , Taiwan

7. Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital , Taipei , Taiwan

Abstract

Abstract Background The benefits of low-dose ketamine for patients with treatment-resistant depression (TRD) and prominent suicidal ideation require further investigation. The effects of treatment refractoriness, the duration of the current depressive episode, and the number of prior antidepressant failures on ketamine efficacy also require clarification. Methods We recruited 84 outpatients with TRD and prominent suicidal ideation—defined as a score ≥4 on item 10 of the Montgomery–Åsberg Depression Rating Scale (MADRS)—and randomized them into 2 groups to receive 0.5 mg/kg ketamine or 0.045 mg/kg midazolam. We assessed depressive and suicidal symptoms prior to infusion; 240 minutes post infusion; and 2, 3, 5, 7, and 14 days post infusion. Results According to the MADRS scores, the antidepressant effect (P = .035) was significantly noted in the ketamine group up to 14 days than in the midazolam group. However, the antisuicidal effect of ketamine, as measured by the Columbia-Suicide Severity Rating Scale Ideation Severity Subscale (P = .040) and MADRS item 10 (P = .023), persisted only 5 days post infusion. Furthermore, the antidepressant and antisuicidal effects of ketamine infusion were noted particularly in patients whose current depressive episode lasted <24 months or whose number of failed antidepressants was ≤4. Conclusions Low-dose ketamine infusion is a safe, tolerable, and effective treatment for patients with TRD and prominent suicidal ideation. Our study highlights the importance of timing; specifically, ketamine is more likely to achieve therapeutic response when the current depressive episode lasted <24 months and the number of failed antidepressants is ≤4.

Funder

Taipei Veterans General Hospital

Yen Tjing Ling Medical Foundation

Ministry of Science and Technology, Taiwan

Taipei, Taichung, Kaohsiung Veterans General Hospital

Tri-Service General Hospital

Academia Sinica Joint Research Program

Veterans General Hospitals

University System of Taiwan Joint Research Program

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Psychiatry and Mental health,Pharmacology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3