Ketamine for treatment-resistant depression

ars to provide significant symptom relief. The study found that two different low dose levels were more effective than an active placebo in reducing depression symptoms over a three-day period. Shrourou, Alina, BSc (October 11, 2018) Researchers identify effective ketamine dosage levels for patients with treatment-resistant depression

The results of this study were published in the October 2018 issue of Molecular Psychiatry. It was led by Massachusetts General Hospital (MGH) investigators and included 99 adults with treatment-resistant depression at six research centers, including Baylor College of Medicine/Debakey VA Medical Center, and University of Texas/Southwestern Medical Center.

Ketamine has been used as a general anesthetic drug for some time. Studies have found it to rapidly relieve depression symptoms when given at low doses. The MGH study focused on determining the optimal dose for effective relief for treatment-resistant depression. To investigate that question, the study tested four different ketamine dosages compared with a placebo. Participants receiving ketamine had significantly greater symptom improvement during the three days after infusion than did those in the control group.

“Treatment resistance in depression is a major issue, with more than half of patients not responding adequately to standard, appropriate antidepressant treatment,” says Maurizio Fava, MD, executive director of the Clinical Trials Network & Institute in the MGH Department of Psychiatry and senior author of the Molecular Psychiatry paper. “There are only a few approved therapies that can help some patients with treatment-resistant depression, so we critically need more options to choose from.”

Co-author Cristina Cusin, MD, who directs the MGH Psychiatry ketamine clinic, says “These results support the clinical observation that one size does not fit all; and each patient needs a tailored treatment plan that may include ketamine, together with other medications and talk therapy.” Fava, the Slater Family Professor of Psychiatry at Harvard Medical School, adds, “Along with supporting the efficacy of intravenous ketamine for patients with treatment-resistant depression, our study also suggests that even lower doses may be effective in some patients. Further investigation should examine the efficacy of repeat doses of ketamine, as well as whether higher doses may require less frequent administration.”

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