Replication of Ketamine's Antidepressant Efficacy in Bipolar Depression: A Randomized Controlled Add-On Trial
| Autor: | Victoria Liberty, Anibal Cravchik, Nancy Diazgranados, David A. Luckenbaugh, Carlos A. Zarate, Lobna Ibrahim, Jessica Selter, Jose A. Franco-Chaves, Nancy E. Brutsche, Craig A. Marquardt |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Bipolar Disorder Hydroxynorketamine Placebo Article Suicidal Ideation Double-Blind Method medicine Humans Ketamine Bipolar disorder Infusions Intravenous Suicidal ideation Biological Psychiatry Cross-Over Studies Depression Ketamine hydrochloride Middle Aged medicine.disease Crossover study Esketamine Treatment Outcome Anesthesia Female medicine.symptom Psychology Excitatory Amino Acid Antagonists medicine.drug |
| Zdroj: | Biological Psychiatry. 71:939-946 |
| ISSN: | 0006-3223 |
| Popis: | Background Currently, no pharmacological treatments for bipolar depression exist that exert rapid (within hours) antidepressant or antisuicidal effects. We previously reported that intravenous administration of the N -methyl-D-aspartate antagonist ketamine produced rapid antidepressant effects in patients with treatment-resistant bipolar depression. The present study sought to replicate this finding in an independent sample. Methods In this double-blind, randomized, crossover, placebo-controlled study, 15 subjects with DSM-IV bipolar I or II depression maintained on therapeutic levels of lithium or valproate received a single intravenous infusion of either ketamine hydrochloride (.5 mg/kg) or placebo on 2 test days 2 weeks apart. The primary outcome measure was the Montgomery-Asberg Depression Rating Scale, which was used to rate overall depressive symptoms at baseline; at 40, 80, 110, and 230 minutes postinfusion; and on days 1, 2, 3, 7, 10, and 14 postinfusion. Results Within 40 minutes, depressive symptoms, as well as suicidal ideation, significantly improved in subjects receiving ketamine compared with placebo ( d = .89, 95% confidence interval=.61–1.16, and .98, 95% confidence interval=.64–1.33, respectively); this improvement remained significant through day 3. Seventy-nine percent of subjects responded to ketamine and 0% responded to placebo at some point during the trial. The most common side effect was dissociative symptoms, which occurred only at the 40-minute time point. Conclusions This study replicated our previous finding that patients with bipolar depression who received a single ketamine infusion experienced a rapid and robust antidepressant response. In addition, we found that ketamine rapidly improved suicidal ideation in these patients. |
| Databáze: | OpenAIRE |
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