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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

Published online by Cambridge University Press:  18 May 2020

Mu-Hong Chen Open the ORCID record for Mu-Hong Chen [Opens in a new window] ,
Wei-Chen Lin ,
Hui-Ju Wu ,
Ya-Mei Bai ,
Cheng-Ta Li ,
Shih-Jen Tsai ,
Chen-Jee Hong ,
Pei-Chi Tu ,
Chih-Ming Cheng  and
Tung-Ping Su
Mu-Hong Chen
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Wei-Chen Lin
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Hui-Ju Wu
Affiliation:
Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan
Ya-Mei Bai
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan
Cheng-Ta Li
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Shih-Jen Tsai
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Chen-Jee Hong
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Pei-Chi Tu
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Department of Medical Research, Veterans General Hospital, Taipei, Taiwan
Chih-Ming Cheng
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
Tung-Ping Su*
Affiliation:
Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Veterans General Hospital, Taipei, Taiwan Department of Medical Research, Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
*
*Tung-Ping Su Email: [email protected]
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Abstract

Background

The 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.

Methods

In 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.

Results

Patients 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.

Conclusions

Low-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.

Keywords

Ketaminetreatment-resistant depressionanxious depression.
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 4 , August 2021 , pp. 362 - 367
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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