期刊
BIPOLAR DISORDERS
卷 22, 期 8, 页码 831-840出版社
WILEY
DOI: 10.1111/bdi.12941
关键词
bipolar depression; intravenous ketamine; NMDA; suicidal ideation; treatment-resistant depression
资金
- Stanley Medical Research Institute
- Canadian Institutes of Health Research/Global Alliance for Chronic Diseases/National Natural Science Foundation of China
- Alkermes
- Lundbeck
- Otsuka
- Takeda
- Sunovion
- Minerva
- National Health and Medical Research Council
- Australian Rotary Health, NSW Health
- American Foundation for Suicide Prevention, Ramsay Research and Teaching Fund
- Elsevier
- AstraZeneca
- Servier
- Allergan Angelini Apsen Boheringer Ingelheim Daiichi Sankyo Brasil Farmaceutica Doc Generici FB-Health Italfarmaco Janssen Lundbeck Mylan Otsuka Pfizer Recordati Sanofi
- National Institute of Mental Health
- Elan Pharma International Limited
- Pathway Genomics, Stanley Medical Research Institute
- National Institute on Drug Abuse
- Allergan, Inc
- Department of Psychiatry, University of Toronto
- Canadian Institutes of Health Research
- Medical Psychotherapy Association Canada
- Canadian Cancer Society
- Canadian Psychiatric Association
- American Psychiatric Association
- American Society of Psychopharmacology, University of Toronto, University Health Network Centre for Mental Health
- Joseph M. West Family Memorial Fund
- VA Cooperative Studies Program
Objective To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD). Method Adults (N = 201) with treatment-resistant MDD or BD received repeat-dose IV ketamine treatment at a community-based clinic. Mixed features were measured using symptoms of anxiety, irritability, and agitation (AIA), as measured by the Generalized Anxiety Disorder-7 (GAD-7) scale. The Quick Inventory for Depressive Symptomatology Self-Report-16 (QIDS-SR16) was used to measure overall treatment response, and the QIDS-SR(16)suicidal ideation (SI) item was used to measure change in SI symptoms with ketamine treatment. The anxiety, irritability, and agitation items on the GAD-7 were used to assess effectiveness of IV ketamine in treating symptoms of mixed features. Results In this retrospective analysis, 113 participants met AIA criteria. Participants with AIA experienced a significantly greater reduction in overall depressive symptoms (F(1, 558) = 9.49,P = .002), SI (F(1, 558) = 3.103,P = .079), anxiety (F(1, 198) = 5.52,P = .007), irritability (F(1, 198) = 28.35,P < .001), and agitation as measured by trouble relaxing (F(1, 198) = 6.70,P = .010) from baseline compared to the non-AIA group, regardless of number of treatments received. Conclusions Our preliminary results suggest that IV ketamine is effective in rapidly treating AIA and SI in adults with treatment-resistant mood disorders. This observation suggests that IV ketamine could be considered a treatment alternative for adults with MDD or BD presenting with mixed features.
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