IN Esketamine and IV Ketamine: Results of a multi-site observational study assessing the effectiveness and tolerability of two novel therapies for treatment-resistant depression.

ObservationalPubMedPubMed ✓September 2, 2024PMID: 39128167 DOI

Abstract

Intravenous (IV) ketamine and intranasal (IN) esketamine are novel therapies to manage treatment resistant depression within major depressive disorder (MDD-TRD). This is a multi-site observational study aiming to assess the real-world effectiveness and tolerability of these novel therapies in the management of MDD-TRD. 53 patients were referred to receive IV ketamine (n = 26, 69.23 % female, 52.81 14.33 years old) or IN esketamine (n = 27, 51.85 % female, 43.93 13.57 years old). Treatment effectiveness was assessed using the Montgomery and sberg Depression Rating Scale (MADRS) for depression severity and item 10 of the MADRS for suicidal ideation (SI). Tolerability was assessed by systematically tracking side effects and depersonalization using the 6-item Clinician administered dissociative symptom scale (CADSS-6). The data was analyzed using descriptive statistics, risk ratio and effect size. Both IV ketamine and IN esketamine significantly reduced depressive symptoms and suicidal ideation by treatment endpoint. Patients receiving IN esketamine, and patients receiving IV ketamine had a similar risk of developing side effects. All side effects reported were mild and transient. These results suggested that both IV ketamine and IN esketamine are effective in the management of depressive symptoms and were well tolerated. Therefore, the results of this study could serve to inform clinical practice.

Authors (13)

Gilmar GutierrezLeadDepartment of Psychiatry, Queen's University, and Providence Care, Kingston, Ontario, Canada.

Jennifer SwainsonDepartment of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.

Nisha RavindranDepartment of Psychiatry, University of Toronto, Toronto, ON. Centre for Addiction and Mental Health, Toronto, ON, Canada.

Raymond W LamDepartment of Psychiatry, University of British Columbia, Vancouver, BC, Canada.

Peter GiacobbeDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada. Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Ganapathy KarthikeyanAlberta Hospital Edmonton / Medical Director of Envision Mind Care, Edmonton, Alberta, Canada.

Annette KowaraDepartment of Psychiatry, University of Toronto, Toronto, ON. Centre for Addiction and Mental Health, Toronto, ON, Canada.

André DoDepartment of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.

Anusha BaskaranDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada. Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Sean Michael NestorDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada. Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Melody J Y KangCentre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada; Imaging Genetics Centre, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, USA.

Aleksandar BioracDepartment of Psychiatry, Queen's University, and Providence Care, Kingston, Ontario, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.

Gustavo VazquezDepartment of Psychiatry, Queen's University, and Providence Care, Kingston, Ontario, Canada; Providence Care Hospital, Kingston, Ontario, Canada. Electronic address: g.vazquez@queensu.ca.

MeSH Terms

HumansKetamineFemaleDepressive Disorder, Treatment-ResistantMaleAdultMiddle AgedAdministration, IntranasalSuicidal IdeationMajor Depressive DisorderAntidepressive AgentsAdministration, IntravenousAgedTreatment Outcome

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Metadata

Study TypeObservational

SourcePubMed

Publication DateSeptember 2, 2024

Citations0

Data Confidence

100

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