Acute antidepressant effects of intramuscular versus intravenous ketamine.
OBJECTIVE
Conventional antidepressants take two weeks before their therapeutic action begins. Recent studies have reported on the rapid antidepressant effect of ketamine when given as an intravenous (I.V.) infusion. Little is known about its intramuscular (I.M.) use in depression. Hence this study was conducted to compare the safety, tolerability and efficacy of I.M. versus. I.V. ketamine in Major Depression (ICD-10).


METHODS
It was a randomized open label parallel group study in a tertiary care teaching hospital. Study sample consisted of 27 subjects having major depression divided randomly into three groups of nine subjects each. Ketamine administered to each group in the dose of 0.5 mg/kg as an I.V. infusion, as 0.5 mg/kg I.M. or 0.25 mg/kg I.M. respectively. Depression rated on the Hamilton Depression Rating Scale (HAM-D) before the injection, two hours later, the next day, and after three days. Data analyzed using the Statistical Package for Social Sciences (SPSS).


RESULTS
Mean age of the sample was 36.81 years (SD 11.815). Two hours after the injection, HAM-D fell by 58.86%, 60.29% & 57.36% in each group respectively. The improvement was sustained for next three days. Adverse effects noticed were rare, of mild nature and transient, lasting less than an hour.


CONCLUSIONS
Intramuscular ketamine in the dose of 0.25 mg/kg is as effective and safe as 0.5 mg/kg given either I.M. or I.V., substantially alleviating depressive symptoms within a few hours and sustained for 3 days.
Department of Psychiatry, Malla Reddy Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Harihar
H
Chilukuri
Department of Anaesthesia, Narayana Medical College, Nellore, Andhra Pradesh, India.
Narasimha Pothula
NP
Reddy
Department of Pharmacology, Narayana Medical College, Nellore, Andhra Pradesh, India.
Ram Mohan
RM
Pathapati
Department of Psychiatry, Narayana Medical College, Nellore, Andhra Pradesh, India.
Arkalgud Nagesha
AN
Manu
Department of Psychiatry, Narayana Medical College, Nellore, Andhra Pradesh, India.
Sharada
S
Jollu
Department of Statistics, Narayana Medical College, Nellore, Andhra Pradesh, India.
Ahammed Basha
AB
Shaik
Acute antidepressant effects; antidepressant drugs; depression; intramuscular ketamine; intravenous ketamine; suicidal risk