Rapid Antidepressant Response with Ketamine: Is it the Solution to Resistant Depression?
BACKGROUND
Treatment-resistant depression (TRD) is a relatively common condition, challenging the clinician. There is an urgent need to develop pharmacological treatments for TRD that exert rapid and sustained antidepressant effects. Ketamine induces a rapid antidepressant effect.


OBJECTIVE
In India, very few studies have corroborated such findings, and the present study aimed to assess the effectiveness and sustainability of antidepressant effects of ketamine in subjects with TRD.


METHODS
The present study was a single-center, prospective, 4-week, open-label, single-arm pilot study. Twenty-two subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depression (treatment resistant) were recruited. After a 2-week drug-free period, subjects were given a single intravenous infusion of ketamine hydrochloride (0.5 mg/kg) and were rated at baseline and at 40, 80, 110, and 230 min and 1, 2, 3, 4, 7, and 14 days postinfusion. The main outcome measure was changes in scores on the 17-item Hamilton Depression Rating Scale (HDRS). Data were analyzed by using Freidman's analysis of variance and a post hoc test.


RESULTS
The ketamine infusion was effective in reducing the HDRS scores, and the change remained significant from minute 80 to day 3 postinfusion at each time point. The change was not significant at any time after day 3.


CONCLUSIONS
The real strength of this study rests in documenting the rapid, albeit short-lived, antidepressant effect of ketamine in TRD.
Department of Psychiatry, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Rajarshi Guha
RG
Thakurta
Paramita
P
Ray
Dipankar
D
Kanji
Ranjan
R
Das
Bikash
B
Bisui
Om Prakash
OP
Singh