Key points:
- Six weeks of intravenous ketamine treatment provided symptom relief for veterans with treatment resistant depression.
- Nearly half of these veterans saw a meaningful drop in depression scores, one quarter had their depression score drop by half, and fifteen percent were officially in remission.
- This study can inform future protocols for the use of IV ketamine as it provides data about its effects in the current clinical practice.
Ketamine is a promising treatment for depression, but few studies have revealed how well it works in real world settings. Now, a study, published in the Journal of Clinical Psychiatry, reveals intravenous (IV) doses of ketamine provided depression relief for veterans with treatment resistant depression.
Researchers analyzed data from the Veteran’s Affairs (VA) national patient record systems, which included dates and locations of ketamine infusions, scores on standardized depression questionnaires, and details about diagnoses and mental health care.
In the study, 215 veterans with treatment-resistant depression received IV ketamine for six weeks. Many of these veterans had complex mental health diagnoses such as post-traumatic stress disorder, anxiety disorder, alcohol use disorder, and substance use disorder. Nearly half saw a meaningful drop in depression scores, while one quarter had their depression score drop by half. Fifteen percent of the veterans were officially in remission at the end of their six-week treatment.
Ketamine has received attention for its ability to rapidly improve depression, but its longer-term impacts are not well studied. However, this study can inform protocols for the use of IV ketamine as it provides data about the effects of IV ketamine in the current clinical practice.
“It’s not a silver bullet,” said study lead Paul Pfeiffer, professor at University of Michigan. “But when we see these patients in our clinic, who have been through every treatment available and nothing has worked, to have even a quarter achieve a significant measurable response is very good.”
Looking ahead, the researchers plan to analyze newer data from more patients. This analysis would permit comparison of treatment protocols across hospitals and would help identify risks and characteristics of patients who discontinue treatment. In addition to analysis, the team and their collaborators are studying the use of ketamine alongside electroconvulsive therapy and repetitive transcranial magnetic stimulation.
“It’s important to remember that ketamine is relatively new as a treatment, and there are multiple ways it can be delivered,” said Pfeiffer. “I think we’re in for an interesting decade of a changing landscape for treatment-resistant depression.