Ketamine for major depressive disorder during an inpatient psychiatric admission: Effectiveness, adverse events, and lessons learned.

Autor: Brody BD; Weill Cornell Medicine/Psychiatry, New York and White Plains, NY, United States of America. Electronic address: Jeb9083@med.cornell.edu., Park N; New York Presbyterian Hospital, United States of America., Christian A; New York Presbyterian Hospital, United States of America., Shaffer CW; Weill Cornell Medicine/Psychiatry, New York and White Plains, NY, United States of America., Smetana R; Weill Cornell Medicine/Psychiatry, New York and White Plains, NY, United States of America., Kotbi N; Weill Cornell Medicine/Psychiatry, New York and White Plains, NY, United States of America., Russ MJ; Silver Hill Hospital, United States of America., Kanellopoulos D; Weill Cornell Medicine/Psychiatry, New York and White Plains, NY, United States of America.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Apr 15; Vol. 351, pp. 293-298. Date of Electronic Publication: 2024 Jan 28.
DOI: 10.1016/j.jad.2024.01.207
Abstrakt: Objective: Most studies examining the efficacy of ketamine for Major Depressive Disorder (MDD) have been conducted in outpatient or mixed inpatient/outpatient settings. Less is known about effectiveness and tolerability of ketamine for psychiatrically hospitalized patients. Efficacy and tolerability data from a naturalistic sample of acute inpatients may help inform institutions considering ketamine therapy for inpatient services.
Methods: We performed a retrospective chart review of inpatients with non-psychotic MDD treated during the initial 3 years of a ketamine infusion program. Treatment effectiveness was defined using change in Montgomery Asberg Depression Rating Scale (MADRS) scores over five infusions. MDD treatment response was defined by a 50 % reduction of MADRS score, and remission was defined as MADRS score ≤ 10 at any point during the treatment. We also report the frequency of adverse events.
Results: 41 patients with MDD were treated and had outcome data. 19 patients (46.5 %) met criteria for response and 15 patients (26.5 %) met criteria for remission during treatment. Four patients (10 %) had adverse psychological or behavioral outcomes.
Limitations: MADRS scales were administered by psychiatrists, psychologists, and trainees in each discipline who did not undergo standardized training in scale administration. Consistent data regarding the race/ethnicity of the patients was not available.
Conclusion: Twice weekly racemic ketamine infusion is an effective treatment option for patients hospitalized with MDD. Unmonitored or at home ketamine therapy may pose substantial risks.
Competing Interests: Declaration of competing interest None of the authors reports receiving external funding for this work, participating in any consulting, or having other financial relationships that represent conflicts of interest.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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