期刊
JOURNAL OF AFFECTIVE DISORDERS
卷 243, 期 -, 页码 516-524出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jad.2018.09.037
关键词
Ketamine; Treatment-resistant depression; Suicidal ideation; Repeat-doses
资金
- American Foundation for Suicide Prevention (AFSP)
- Clinical Research Center at Massachusetts General Hospital
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Clinical and Translational Science Center, from the National Center for Advancing Translational Science [8UL1TR000170-05]
Background: Several studies indicate that ketamine has rapid antidepressant effects in patients with treatment-resistant depression (TRD). The extent to which repeated doses of ketamine (versus placebo) reduce depression in the short and long term among outpatients with TRD and chronic, current suicidal ideation remains unknown. Methods: Twenty-six medicated outpatients with severe major depressive disorder with current, chronic suicidal ideation were randomized in a double-blind fashion to six ketamine infusions (0.5 mg/kg over 45 minutes) or saline placebo over three weeks. Depression and suicidal ideation were assessed at baseline, 240 min post-infusion, and during a three-month follow-up phase. Results: During the infusion phase, there was no differences in depression severity or suicidal ideation between placebo and ketamine (p = 0.47 and p = 0.32, respectively). At the end of the infusion phase, two patients in the ketamine group and one in the placebo group met criteria for remission of depression. At three-month follow-up, two patients in each group met criteria for remission from depression. Limitations: Limitations include the small sample size, uncontrolled outpatient medication regimens, and restriction to outpatients, which may have resulted in lower levels of suicidal ideation than would be seen in emergency or inpatient settings. Conclusions: Repeated, non-escalating doses of ketamine did not outperform placebo in this double-blind, placebo controlled study of patients with severe TRD and current, chronic suicidal ideation. This result may support our previously published open-label data that, in this severely and chronically ill outpatient population, the commonly used dose of 0.5 mg/kg is not sufficient.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据