TY - JOUR
T1 - Time to relapse after a single administration of intravenous ketamine augmentation in unipolar treatment-resistant depression
AU - Salloum, Naji C.
AU - Fava, Maurizio
AU - Hock, Rebecca S.
AU - Freeman, Marlene P.
AU - Flynn, Martina
AU - Hoeppner, Bettina
AU - Cusin, Cristina
AU - Iosifescu, Dan V.
AU - Trivedi, Madhukar H.
AU - Sanacora, Gerard
AU - Mathew, Sanjay J.
AU - Debattista, Charles
AU - Ionescu, Dawn F.
AU - Papakostas, George I.
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objective: To examine the rate and time to relapse for remitters and responders to ketamine in treatment-resistant depression (TRD). Methods: Subjects with TRD were randomized to a single infusion of one of several doses of intravenous ketamine, or midazolam. Using Kaplan-Meier survival function, the current report examines the rate and time to relapse, defined as MADRS ≥ 22, over a period of 30 days, in subjects who achieved remission (MADRS ≤ 10) or response (≥ 50% reduction in MADRS) on day three post-infusion of intravenous ketamine 0.1, 0.5, or 1.0 mg/kg. Results: Of the 60 randomized participants who received a single ketamine (0.1, 0.5, or 1.0 mg/kg) infusion, 19 (34%) met criteria for remission and 27 (48%) for response, on day 3 post-infusion. A numerical dose-response relationship was observed, with remitters/responders on ketamine 1.0 mg/kg having the lowest relapse rate, followed by ketamine 0.5 mg/kg and 0.1 mg/kg, respectively (% of remitters who relapsed by day 14: 38% with 1.0 mg/kg, 50% with 0.5 mg/kg, 100% with 0.1 mg/kg;% of responders who relapsed by day 14: 30% with 1.0 mg/kg, 50% with 0.5 mg/kg, 80% with 0.1 mg/kg). Limitations: The sample size was small. No MADRS measurements at day one post-infusion. The study was not powered to assess differences in relapse prevention between different doses of ketamine. Conclusion: Time to relapse after successful treatment with a single infusion of ketamine appears to follow a dose-response relationship, where higher dosage leads to increased time to relapse.
AB - Objective: To examine the rate and time to relapse for remitters and responders to ketamine in treatment-resistant depression (TRD). Methods: Subjects with TRD were randomized to a single infusion of one of several doses of intravenous ketamine, or midazolam. Using Kaplan-Meier survival function, the current report examines the rate and time to relapse, defined as MADRS ≥ 22, over a period of 30 days, in subjects who achieved remission (MADRS ≤ 10) or response (≥ 50% reduction in MADRS) on day three post-infusion of intravenous ketamine 0.1, 0.5, or 1.0 mg/kg. Results: Of the 60 randomized participants who received a single ketamine (0.1, 0.5, or 1.0 mg/kg) infusion, 19 (34%) met criteria for remission and 27 (48%) for response, on day 3 post-infusion. A numerical dose-response relationship was observed, with remitters/responders on ketamine 1.0 mg/kg having the lowest relapse rate, followed by ketamine 0.5 mg/kg and 0.1 mg/kg, respectively (% of remitters who relapsed by day 14: 38% with 1.0 mg/kg, 50% with 0.5 mg/kg, 100% with 0.1 mg/kg;% of responders who relapsed by day 14: 30% with 1.0 mg/kg, 50% with 0.5 mg/kg, 80% with 0.1 mg/kg). Limitations: The sample size was small. No MADRS measurements at day one post-infusion. The study was not powered to assess differences in relapse prevention between different doses of ketamine. Conclusion: Time to relapse after successful treatment with a single infusion of ketamine appears to follow a dose-response relationship, where higher dosage leads to increased time to relapse.
KW - Ketamine
KW - Major depressive disorder
KW - Relapse
KW - Remission
KW - Treatment-resistant depression
UR - http://www.scopus.com/inward/record.url?scp=85071728685&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071728685&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2019.09.017
DO - 10.1016/j.jad.2019.09.017
M3 - Article
C2 - 31494365
AN - SCOPUS:85071728685
SN - 0165-0327
VL - 260
SP - 131
EP - 139
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -