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.
Gilmar Gutierrez, Jennifer Swainson, Nisha Ravindran, Raymond W Lam, Peter Giacobbe, Ganapathy Karthikeyan, Annette Kowara, André Do, Anusha Baskaran, Sean Michael Nestor, Melody J Y Kang, Aleksandar Biorac, Gustavo Vazquez
Psychiatry research October 1, 2024 DOI: 10.1016/j.psychres.2024.116125 via PubMed
Summary
AI-generated from the abstractBoth intravenous ketamine and intranasal esketamine significantly reduce depressive symptoms and suicidal ideation in people with treatment-resistant major depressive disorder. In a multi-site observational study of 53 patients, those receiving IV ketamine (26 patients, average age 52.8) and those receiving IN esketamine (27 patients, average age 43.9) showed similar improvements in depression severity and suicidal thoughts. Side effects were mild and temporary, with no significant difference in risk between the two treatments. The findings suggest both therapies are effective and well tolerated for treatment-resistant depression.
Study at a glance
| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 53 |
| Population | Patients with treatment-resistant major depressive disorder |
| Interventions | IV ketamine IN esketamine |
| Topics | Depression |
| Keywords | Antidepressant effect Depressive symptoms Psychopharmacology Real-world clinical data |
| Citations | 17 |
| Key finding | Both IV ketamine and IN esketamine significantly reduced depressive symptoms and suicidal ideation with mild, transient side effects. |
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 Åsberg 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.