title: Ketamine augmentation rapidly improves depression scores in inpatients with treatment-resistant bipolar depression.
abstract: OBJECTIVE
  To study the clinical effect of a single ketamine infusion, 0.5 mg/kg body weight, in bipolar depressive patients receiving mood-stabilising drugs, not improving on antidepressants. Previously, in such patients, we had found a correlation between clinical efficacy, serum brain-derived neurotrophic factor and vitamin B12 levels and a rapid improvement in neurocognitive performance.
  
  
  METHODS
  The study included 53 patients (13 men, 40 women), aged 22-81 years, receiving ≥1 mood-stabilising medications of the first and/or second generation. Pre-infusion depression intensity on the Hamilton Depression Rating Scale (HDRS) was 23.4 ± 4.6 points and the assumed criterion for response was a reduction of ≥50% in the HDRS score after 7 days.
  
  
  RESULTS
  Twenty-seven subjects (51%) met a criterion for response, more frequently males (77%) than females (43%). Responders did not differ from non-responders as to age, illness onset, duration of depressive episode, type of bipolar illness, family history of psychiatric illness, personal/family history of alcoholism or using lithium, quetiapine or a combination of these mood stabilisers.
  
  
  CONCLUSIONS
  The results confirm a rapid antidepressant effect of ketamine infusion in a considerable proportion of those patients with bipolar depression receiving mood-stabilising drugs. Apart from male gender, no other clinical factors were predictors of response.
authors.affiliation: a Department of Adult Psychiatry , Poznan University of Medical Sciences , Poznan , Poland.
authors.forename: Janusz K
authors.initials: JK
authors.lastname: Rybakowski
authors.affiliation: a Department of Adult Psychiatry , Poznan University of Medical Sciences , Poznan , Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Permoda-Osip
authors.affiliation: b Department of Pediatric Anaesthesiology and Intensive Therapy , Poznan University of Medical Sciences , Poznan , Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Bartkowska-Sniatkowska
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs; D007649:Ketamine
keywords: Ketamine; bipolar; depression; efficacy