At-Home, Sublingual Ketamine Therapy Rapidly Improves Anxiety, Depressive Symptoms

Sublingual, at-home ketamine-assisted therapy over 4 weeks was safe and effective for patients with moderate to severe anxiety and depression in what is thought to be the largest study to date of any type of ketamine treatment. Researchers published their findings in the Journal of Affective Disorders.

“From a chart review of 4334 cases, 1247 individuals had sufficient data to evaluate baseline characteristics, adverse events, dissociation, and clinical outcomes,” researchers wrote. “These data suggested that ketamine-assisted therapy offered clinically meaningful improvement and demonstrated a desirable safety and risk mitigation profile.”

Patients in the prospective study received 4 sessions of ketamine-assisted treatment with psychosocial support and remote monitoring via the Mindbloom telehealth platform. At baseline, most patients were in the moderately-severe category for depression per Patient Health Questionnaire (PHQ-9) scores and in the severe category for anxiety per Generalized Anxiety Disorder (GAD-7) scale scores.

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According to the findings, 89% of participants experienced improvement in depression and/or anxiety symptoms after 4 sessions. Some 63% of participants experienced a 50% or greater improvement on the PHQ-9 or GAD-7 scale. Remission rates were 32.6% for PHQ-9 and 31.3% for GAD-7. Additionally, 62% of patients with suicidal ideation before treatment reported no suicidal ideation at the end of the 4 weeks.

Less than 1% of patients worsened on the PHQ-9 or GAD-7, the study showed, and 6 patients dropped out of treatment due to adverse events.

“The combination of strong and rapid effects with very small numbers of adverse events suggest that at-home sublingual ketamine therapy is an important avenue for overcoming long-standing barriers to depression and anxiety treatment, safely and conveniently,” researchers wrote. “Evaluating the durability of these effects will be important for future research.”

References

Hull TD, Malgaroli M, Gazzaley A, et al. At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: findings from a large, prospective, open-label effectiveness trial. J Affect Disord. Published online July 6, 2022. doi: 10.1016/j.jad.2022.07.004

Largest-ever clinical study of ketamine therapy shows that at-home model can be a safe, effective treatment for anxiety and depression; 62% fewer patients report suicidal ideation after four sessions. News release. Mindbloom; July 18, 2022. Accessed July 29, 2022.