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Efficacy of low-dose ketamine infusion in anxious vs nonanxious depression: revisiting the Adjunctive Ketamine Study of Taiwanese Patients with Treatment-Resistant Depression
CNS Spectrums ( IF 3.3 ) Pub Date : 2020-05-18 , DOI: 10.1017/s1092852920001194 Mu-Hong Chen, Wei-Chen Lin, Hui-Ju Wu, Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong, Pei-Chi Tu, Chih-Ming Cheng, Tung-Ping Su
CNS Spectrums ( IF 3.3 ) Pub Date : 2020-05-18 , DOI: 10.1017/s1092852920001194 Mu-Hong Chen, Wei-Chen Lin, Hui-Ju Wu, Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong, Pei-Chi Tu, Chih-Ming Cheng, Tung-Ping Su
BackgroundThe antidepressant effect of low-dose ketamine infusion on Taiwanese patients with anxious vs nonanxious treatment-resistant depression (ANX-TRD vs NANX-TRD) has remained unknown.MethodsIn total, 71 patients with TRD were randomized to three groups. Each group had participants who received saline infusions mixed with 0 (a normal saline infusion), 0.2, and 0.5 mg/kg of ketamine. Participants were followed up for 2 weeks. Anxious depression was defined as major depressive disorder with a total score of 7 or more on the 17-item Hamilton Depression Rating Scale Anxiety-Somatization factor. Generalized estimating equation models were used to investigate the effects of treatment (ketamine vs placebo) and depression type (ANX-TRD vs NANX-TRD) in the reduction of depressive symptoms during the follow-up period.ResultsPatients with ANX-TRD were less likely to respond to a single low-dose ketamine infusion than those with NANX-TRD. Among patients with NANX-TRD, low-dose ketamine infusion was significantly superior to placebo for reducing depressive symptoms. However, among patients with ANX-TRD, ketamine was not superior to placebo; nonetheless, approximately 30% of the patients responded to ketamine infusion compared to 13% who responded to the placebo.ConclusionsLow-dose ketamine infusion was effective for Taiwanese patients with NANX-TRD but not so effective for those with ANX-TRD. A higher level of anxiety severity accompanying depression was related to greater depression severity. This may confound and reduce the antidepressant effect of ketamine infusion.
更新日期：2020-05-18
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