Ketamine Infusions in Depression: Evaluating Long-term Efficacy and Infusion Protocols
This study provides a detailed analysis of the long-term clinical outcomes and infusion protocols of intravenous ketamine in treating major depressive disorder (MDD). It offers valuable insights for physicians managing patients with depression, particularly in the context of treatment resistance and chronic management.
Study Design:
- Participants: 215 patients from the Veterans Health Administration, treated in Fiscal Year 2020.
- Methodology: Analysis of IV ketamine infusions and associated Patient Health Questionnaire-9 (PHQ-9) scores.
- Baseline Data: Mean PHQ-9 score of 18.6, average of 2.1 antidepressant trials in the past year, and 6.1 trials in the past 20 years.
Key Findings:
- Infusion Frequency: Decreased from every 5 days to every 3-4 weeks over the first 5 months, totaling an average of 18 infusions over 12 months.
- Clinical Outcomes: After 6 weeks, 26% showed a 50% improvement in PHQ-9 score (response) and 15% achieved a score ≤ 5 (remission), sustained over 6 months.
- Demographics and Comorbidities: No significant correlation with 6-week PHQ-9 scores.
HCN Medical Memo
In this study on IV ketamine for depression, although only a small percentage of patients showed significant improvement or full remission, those who did experience symptom relief saw these improvements maintained for at least six months. This was achieved with a progressively reduced frequency of ketamine infusions.
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