Effects of Ketamine in Treatment-Refractory Obsessive-Compulsive Disorder
| Autor: | Christopher Pittenger, Gerard Sanacora, James F. Leckman, Angeli Landeros-Weisenberger, Michael H. Bloch, Kaitlyn E. Panza, Eileen Billingslea, Zubin Bhagwagar, Suzanne Wasylink, John H. Krystal |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Obsessive-Compulsive Disorder Adolescent behavioral disciplines and activities Article Obsessive compulsive mental disorders medicine Humans Ketamine Biological Psychiatry Depression (differential diagnoses) Psychiatric Status Rating Scales Depression Treatment refractory Patient Selection Antagonist Middle Aged medicine.disease Antidepressive Agents Clinical trial Treatment Outcome Anesthesia Major depressive disorder Antidepressant Female Psychology Excitatory Amino Acid Antagonists medicine.drug |
| Zdroj: | Biological Psychiatry. 72:964-970 |
| ISSN: | 0006-3223 |
| Popis: | Treatments for obsessive-compulsive disorder (OCD) usually lead to incomplete symptom relief and take a long-time to reach full effect. Convergent evidence suggests that glutamate abnormalities contribute to the pathogenesis of OCD. Ketamine is a potent noncompetitive antagonist of the N-methyl-D-aspartate glutamate receptor. Trials have reported rapid antidepressant effects after low-dose ketamine infusion.We conducted an open-label trial of ketamine (.5 mg/kg IV over 40 min) in 10 subjects with treatment-refractory OCD. Response was defined as35% improvement in OCD symptoms and50% improvement in depression symptoms from baseline at any time between 1 and 3 days after infusion.None of 10 subjects experienced a response in OCD symptoms in the first 3 days after ketamine. Four of seven patients with comorbid depression experienced an antidepressant response to ketamine in the first 3 days after infusion. Both OCD and depression symptoms demonstrated a statistically significant improvement in the first 3 days after infusion compared with baseline, but the OCD response was12%. The percentage reduction in depressive symptoms in the first 3 days after ketamine infusion was significantly greater than the reduction in OCD symptoms.Ketamine effects on OCD symptoms, in contrast to depressive symptoms, did not seem to persist or progress after the acute effects of ketamine had dissipated. |
| Databáze: | OpenAIRE |
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