The effectiveness of intravenous ketamine in adults with treatment-resistant major depressive disorder and bipolar disorder presenting with prominent anxiety: Results from the Canadian Rapid Treatment Center of Excellence

Oct 12, 2020Journal of psychopharmacology (Oxford, England)

Intravenous ketamine's effectiveness for adults with hard-to-treat depression and bipolar disorder who have strong anxiety

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Abstract

A total of 209 adults with treatment-resistant depression and bipolar disorder were analyzed, with 94 patients meeting criteria for high anxiety symptoms.

Individuals with treatment-resistant depression and high anxiety symptoms showed a greater reduction in overall depressive symptoms after four ketamine infusions compared to those without high anxiety.
Both groups experienced significant reductions in suicidal ideation following four infusions.
Anxiety symptoms decreased significantly more in the high anxiety group after three and four infusions compared to the low anxiety group.

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BACKGROUND: Individuals meeting criteria for treatment-resistant depression (TRD) are differentially affected by high levels of anxiety symptoms.

AIMS: There is a need to identify the efficacy of novel rapid-onset treatments in adults with mood disorders and comorbid anxious-distress.

METHODS: This study included patients with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD) who were receiving intravenous (IV) ketamine treatment at a community-based clinic.Anxious-distress was proxied using items from the Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR) and Generalized Anxiety Disorder 7-item (GAD7) scales. The difference in QIDS-SRtotal score, QIDS-SRsuicidal ideation (SI) item and GAD7 score were analyzed between groups. 16 16 16

RESULTS: A total of 209 adults with MDD (= 177) and BD (= 26) were included in this analysis. From this sample, 94 patients (mean = 45 ± 13.9 years) met the criteria for anxious-distress. Individuals meeting the criteria for anxious-distress exhibited a significantly greater reduction in QIDS-SRtotal score following four infusions (= 0.02) when compared with patients not meeting the anxious-distress criteria. Both anxious-distressed and low-anxiety patients exhibited a significant reduction in SI (< 0.0001) following four infusions.Finally, there was a significantly greater reduction in anxiety symptoms in the anxious-distress group compared with the non-anxious distress group following three (= 0.02) and four infusions (< 0.001). n n p p p p16

CONCLUSION: Patients with TRD and prominent anxiety receiving IV ketamine exhibited a significant reduction in depressive, SI and anxiety symptoms.

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The effectiveness of intravenous ketamine in adults with treatment-resistant major depressive disorder and bipolar disorder presenting with prominent anxiety: Results from the Canadian Rapid Treatment Center of Excellence

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