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One-third of Patients With MDD Responded to Ketamine Therapy

Evi Arthur

Only one-third of patients with major depressive disorder (MDD) benefitted from ketamine therapy, according to study results published ahead of print in the Journal of Affective Disorders.

“In an independent sample, we confirmed the presence of 3 previously reported distinct trajectories of antidepressant response to IV ketamine,” researchers noted. “This finding is also consistent with other studies that have demonstrated pretreatment characteristics and early treatment change patterns are associated with differential responses to treatment.”

Related: How does walking affect MDD symptoms?

Researchers performed growth mixture modeling on data from 298 patients with MDD who were treated with intravenous (IV) ketamine at an outpatient community clinic. Changes in depression were measured using the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) over 6 clinic visits. Patients had “relatively severe depression” (a QIDS-SR score of 16.61) before treatment and had previously not responded to at least 2 medications. Participants had a mean age of 40 years and were majority male (58.4%).

The patients were split into 3 trajectory groups to best demonstrate changes in depression symptoms over the course of treatment. Patients in 2 of the groups had severe depression before treatment, but 1 group (n=78) showed modest improvement, and the other showed rapid improvement after treatment (n=103). The third group (n=117) started with moderate depression and showed moderate improvement. Suicidality was higher in the more-severe depression groups and the change in severity was similar to the change in depression. 

“This replication study in an independent community-based ketamine clinic sample revealed similar response trajectories, with only about a third of depressed patients benefitting substantially from an acute induction course of ketamine infusions,” researchers concluded.

Reference
O’Brien B, Lee J, Kim S, et al. Replication of distinct trajectories of antidepressant response to intravenous ketamine. J Affect Disord. 2023;321: 140-146. doi.org/10.1016/j.jad.2022.10.031

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