Relationship of ketamine's antidepressant and psychotomimetic effects in unipolar depression
Language English Country Sweden Media print
Document type Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
23803871
PII: NEL340413A06
Knihovny.cz E-resources
- MeSH
- Antidepressive Agents therapeutic use MeSH
- Depressive Disorder, Major drug therapy MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Hallucinogens therapeutic use MeSH
- Infusions, Intravenous MeSH
- Ketamine therapeutic use MeSH
- Cross-Over Studies MeSH
- Middle Aged MeSH
- Humans MeSH
- Receptors, N-Methyl-D-Aspartate antagonists & inhibitors MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- Antidepressive Agents MeSH
- Hallucinogens MeSH
- Ketamine MeSH
- Receptors, N-Methyl-D-Aspartate MeSH
OBJECTIVES: Ketamine and other NMDA (N-methyl-D-aspartate) antagonists produce fast-acting antidepressant-like effects, although the underlying mechanism is unclear. Furthermore, high affinity NMDA antagonists such as ketamine are associated with psychotomimetic effects. To date the link between the antidepressant and psychotomimetic effects of ketamine has not been explored. We examined the relationship between the antidepressant and psychotomimetic effects of a single ketamine infusion in subjects diagnosed with major depressive disorder. METHODS: In a double-blind, cross-over, placebo-controlled, two weeks clinical trial we studied the effects of ketamine (0.54 mg/kg within 30 min) in a group of 27 hospitalized depressive patients. RESULTS: Higher intensity of psychotomimetic symptoms, measured using BPRS, during ketamine administration correlated with alleviation in mood ratings during the following week with maximum on day seven. Ketamine was superior to placebo in all visits (day 1, 4, and 7) assessed by MADRS with effect size (Cohen´s d) of 0.62, 0.57, and 0.44 respectively. There was no significant correlation between ketamine and nor-ketamine plasma levels and MADRS score change at any study time point. CONCLUSION: The substantial relationship between ketamine's antidepressant and psychotomimetic effects was found. This relationship could be mediated by the initial steps of ketamine's action, trough NMDA receptors, shared by both ketamine's clinical effects.
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