The effects of ketamine on symptoms of depression and anxiety in real-world care settings: A retrospective controlled analysis.

Autor: Hietamies TM; Stanford University School of Medicine, Stanford, CA, USA; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: tuulihi@stanford.edu., McInnes LA; Osmind, San Francisco, CA, USA. Electronic address: alison@osmind.org., Klise AJ; Imagine Medical Group, DBA InnvaTel Telepsychiatry, 228 Park Ave S, PMB 36149, NY 10003, New York. Electronic address: andrew.klise@innovatel.com., Worley MJ; Osmind, San Francisco, CA, USA. Electronic address: matthew.worley@osmind.org., Qian JJ; Stanford University School of Medicine, Stanford, CA, USA; Osmind, San Francisco, CA, USA. Electronic address: jimmy@osmind.org., Williams LM; Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: leawilliams@stanford.edu., Heifets BD; Stanford University School of Medicine, Stanford, CA, USA; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: bheifets@stanford.edu., Levine SP; Heading Health, Austin, TX, USA; Compass Pathways, UK. Electronic address: steve@headinghealth.com.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2023 Aug 15; Vol. 335, pp. 484-492. Date of Electronic Publication: 2023 May 16.
DOI: 10.1016/j.jad.2023.04.141
Abstrakt: Introduction: Ketamine intravenous therapy (KIT) appears effective for treating depression in controlled trials testing a short series of infusions. A rapidly proliferating number of clinics offer KIT for depression and anxiety, using protocols without a strong evidence basis. Controlled comparison of mood and anxiety from real-world KIT clinics, and the stability of outcomes, is lacking.
Methods: We performed a retrospective controlled analysis on patients treated with KIT in ten community clinics across the US, between 08/2017-03/2020. Depression and anxiety symptoms were evaluated using the Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS) and the Generalized Anxiety Disorder 7-item (GAD-7) scales, respectively. Comparison data sets from patients who did not undergo KIT were obtained from previously published real-world studies.
Results: Of 2758 patients treated, 714 and 836 met criteria for analysis of KIT induction and maintenance outcomes, respectively. Patients exhibited significant and concordant reduction in both anxiety and depression symptoms after induction (Cohen's d = -1.17 and d = -1.56, respectively). Compared to two external datasets of KIT-naive depressed patients or patients starting standard antidepressant therapy, KIT patients experienced a significantly greater reduction in depression symptoms at eight weeks (Cohen's d = -1.03 and d = -0.62 respectively). Furthermore, we identified a subpopulation of late-responders. During maintenance, up to a year post-induction, increases in symptoms were minimal.
Limitations: Due to the retrospective nature of the analyses, interpreting this dataset is limited by incomplete patient information and sample attrition.
Conclusions: KIT treatment elicited robust symptomatic relief that remained stable up to one year of follow-up.
Competing Interests: Declaration of competing interest Drs Hietamies and Klise have no conflicts of interest or disclosures to report. Dr. Worley is an employee of Osmind. Jimmy Qian is an employee of Osmind. Dr. McInnes is an employee of Osmind and a scientific advisor for Clexio Biosciences Ltd. Dr. Williams is a scientific advisor for One Mind Psyberguide and declares US Pants. App. 10/034,645 and 15/820,338: Systems and methods for detecting complex networks in MRI image data. Dr. Heifets is a scientific advisor for Osmind and Journey Clinical and is also a consultant for Clairvoyant Therapeutics and Vine Ventures Dr. Levine was Founder, president, and shareholder of Actify Neurotherapies (ceased operations March 2020). He is currently employed by Compass Pathways LLC.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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