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. 2023 Aug;37(8):775-783.
doi: 10.1177/02698811231171531. Epub 2023 May 16.

Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth

Noah Chisamore  1 , Kevork Danayan  1 , Nelson B Rodrigues  1   2   3 , Joshua D Di Vincenzo  1   2   3 , Shakila Meshkat  1   2   3 , Zoe Doyle  3 , Rodrigo Mansur  1   2   3 , Lee Phan  1   2   3 , Farhan Fancy  1   2   3 , Edmond Chau, Aniqa Tabassum  1   2   3 , Kevin Kratiuk  3 , Anil Arekapudi  1 , Roger S McIntyre  1   2   3 , Joshua D Rosenblat  1   2   3
Affiliations

Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth

Noah Chisamore et al. J Psychopharmacol. 2023 Aug.

Abstract

Background: Ketamine is an emerging treatment for treatment-resistant depression (TRD) associated with rapid and robust improvements in depressive symptoms and suicidality. However, the efficacy and safety of ketamine in transitional age youth (TAY; age 18-25) populations remains understudied.

Methods: In this retrospective analysis, TAY patients (n = 52) receiving ketamine for TRD were matched for sex, primary diagnosis, baseline depression severity, and treatment resistance with a general adult (GA) sample (age 30-60). Patients received four ketamine infusions over 2 weeks (0.5-0.75 mg/kg over 40 min). The primary outcome was the change in Quick Inventory of Depressive Symptomatology Self-Report 16-item (QIDS-SR16) over time. Secondary outcomes were changes in QIDS-SR16 suicidal ideation (SI) item, anxiety (Generalized Anxiety Disorder 7-item (GAD-7)), and adverse effects (ClinicalTrials.gov: NCT04209296).

Results: A significant main effect of infusions on reduction of total QIDS-SR16 (p < 0.001), QIDS-SR16 SI (p < 0.001), and GAD-7 (p < 0.001) scores was observed in the TAY group with moderate effect sizes, indicative of clinically significant improvements in depression, anxiety, and suicidality. There were no significant differences between TAY and GA groups on these measures over time, suggesting comparable improvements in both groups. Safety and tolerability outcomes were comparable between groups with only mild, transient adverse effects observed.

Conclusion: Ketamine was associated with comparable clinical benefits, safety, and tolerability in a TAY sample as compared to a matched GA TRD sample.

Keywords: Depression; ketamine; major depressive disorder; transitional age youth; treatment-resistant depression.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Joshua Rosenblat has received research grant support from the Canadian Institute of Health Research (CIHR), Physician Services Inc Foundation, Labatt Brain Health Network, Brain and Cognition Discovery Foundation, Canadian Cancer Society, Canadian Psychiatric Association, Academic Scholars Award, American Psychiatric Association, American Society of Psychopharmacology, University of Toronto, University Health Network Centre for Mental Health, Joseph M. West Family Memorial Fund, and Timeposters Fellowship and industry funding for speaker/consultation/research fees from iGan, Boehringer Ingelheim, Janssen, Allergan, Lundbeck, Sunovion, and COMPASS. He is the Chief Medical and Scientific Officer of Braxia Scientific and the medical director of the Canadian Rapid Treatment Centre of Excellence (Braxia Health). Dr Roger S McIntyre has received research grant support from Global Alliance for Chronic Diseases/CIHR/National Natural Science Foundation of China’s Mental Health Team Grant; speaker/consultation fees from Lundbeck, Janssen, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Abbvie. He is a CEO of Braxia Scientific Corp. Kevin Kratiuk is the Vice President of Operations at Braxia Health and is a shareholder of Braxia Scientific Corp. No other authors on this manuscript have any potential conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Plots of mean (±SE) QIDS-SR16 total (a), QIDS-SR16 suicidality (b), and GAD-7 total (c) scores baseline to post-treatment assessment in TAY and GA patients. SE: standard error; QIDS-SR16: Quick Inventory of Depressive Symptomatology Self-Report 16-item; GAD-7: Generalized Anxiety Disorder 7-item; TAY: transitional age youth.
Figure 2.
Figure 2.
Plots of mean (±SE) SDS/WPAI work (a), social (b), and family (c) scores at baseline and post-treatment assessment in TAY and GA patients. SE: standard error; SDS: Sheehan Disability Scale; WPAI: Work Productivity and Activity Impairment Questionnaire; TAY: transitional age youth; GA: general adult.
Figure 3.
Figure 3.
Plot of mean (±SE) CADSS-6 score at each infusion in TAY and GA patients. SE: standard error; CADSS: Clinician Administered Dissociative States Scales; TAY: transitional age youth; GA: general adult.
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