In recent years, the use of intravenous (IV) ketamine has gained attention for its rapid antidepressant effects in major depressive disorder. However, its effectiveness in treating bipolar depression has been less explored. A recent real-world study conducted at the Canadian Rapid Treatment Centre of Excellence sheds light on the positive outcomes of repeated ketamine infusions for individuals with treatment-resistant bipolar depression.
The study, registered as NCT04209296, took place at a community clinic in Mississauga, Ontario. Sixty-six patients with treatment-resistant bipolar I/II depression were included in the observational study. Over a two-week period, participants received four sub-anesthetic doses of IV ketamine ranging from 0.5 to 0.75 mg/kg. The researchers assessed the impact of the treatment using validated self-report measures for depression symptoms, suicidality, anxiety, and overall functioning.
The findings revealed both statistically and clinically significant antidepressant effects across the entire sample. The Quick Inventory for Depression Symptomatology-Self Report-16 demonstrated a statistically significant mean reduction of 6.08+/−1.39 in depressive symptoms. Importantly, successive ketamine infusions led to further reductions in depressive symptoms. Notably, there were substantial decreases in suicidal thoughts (QIDS-SR16-Suicide Item) and anxiety levels (Generalized Anxiety Disorder-7), coupled with statistically significant improvements in overall functioning as measured by the Sheehan Disability Scale. After four infusions, the response rate, defined as a total score decrease of ≥50% from baseline on QIDS-SR16, was 35%, while the remission rate, with a total score ≤5, stood at 20%.
The study's conclusion is promising for those grappling with bipolar depression. The real-world effectiveness of IV ketamine was evident, and the repeated doses correlated with greater symptom reduction. Importantly, the treatment was generally well-tolerated, with only a small percentage (4.5%) experiencing treatment-emergent hypomania. Notably, there were zero cases of mania or psychosis. In essence, this research adds to the growing body of evidence supporting the potential of ketamine infusions as a viable treatment option for individuals with treatment-resistant bipolar depression. While more studies are needed, these findings offer hope and underscore the importance of exploring innovative approaches to mental health treatment.....more
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