Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder

Mar 8, 2023Psychiatry research

Ketamine infusions for hard-to-treat depression with borderline personality disorder in real-life settings

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Abstract

In a sample of 100 participants, intravenous ketamine treatment resulted in a significant reduction in depressive symptoms and borderline personality symptoms.

Both groups, BPD-positive and BPD-negative, showed significant improvement in depressive symptoms and functionality after receiving ketamine.
The BPD-positive group had a notable reduction of 5.95 points on the depression severity scale.
Borderline personality symptoms also decreased significantly by 0.64 points in the BPD-positive group.
No significant differences in effectiveness were observed between the BPD-positive and BPD-negative groups.

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Borderline personality disorder (BPD) has high rates of comorbidity with mood disorders, including treatment-resistant depression (TRD). Comorbidity of BPD with depression is associated with poorer response to antidepressants. Intravenous ketamine is a novel treatment for TRD that has not been specifically evaluated in patients with comorbid BPD. In this retrospective analysis of data collected from participants who received care at the Canadian Rapid Treatment Centre of Excellence (CRTCE; Braxia Health; ClinicalTrials.gov: NCT04209296), we evaluated the effectiveness of intravenous ketamine in a TRD population with comorbid BPD (N=100; n=50 BPD-positive compared with n=50 BPD-negative). Participants were administered four doses of intravenous ketamine (0.5-0.75mg/kg over 40 minutes) over two weeks. The primary outcome measures were changes in depressive symptom severity (as measured by Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR)) and borderline symptom severity (as measured by Borderline Symptom List 23-item (BSL-23)). Both BPD-positive and BPD-negative groups improved significantly on the QIDS-SR, QIDS-SRsuicide ideation item, anxiety, and functionality scales with large effect sizes. There was no significant difference between groups. The BPD-positive group exhibited significant reduction of 0.64 on BSL-23 scores and a significant reduction of 5.95 on QIDS-SRscores. Patients with TRD and comorbid BPD receiving ketamine exhibited a significant reduction in symptoms of depression, borderline personality, suicidality, and anxiety. 16 16 16 16

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Real world effectiveness of repeated ketamine infusions for treatment-resistant depression with comorbid borderline personality disorder

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