Veterans with PTSD and major depressive disorder saw significant improvement in suicidal ideation after receiving IV infusions of ketamine over a 12-day period, according to a poster presented at the Anxiety and Depression Association of America annual conference.
Patients with comorbid PTSD and MDD are at three times higher risk for suicide than patients with either disorder alone, Cristina Sophia Albott, MD, from the department of psychiatry, University of Minnesota Medical School, wrote in the abstract.
Previous research has indicated that treatment with ketamine led to rapid improvement of suicidal ideation in people with treatment-resistant depression; therefore, Albott and colleagues examined its effect in a cohort of veterans with suicidal ideation. In their study, 15 veterans with PTSD and MDD who reported suicidal ideation received six repeated IV infusions of 0.5 mg/kg ketamine on a Monday-Wednesday-Friday schedule over 12 days.
Immediately before and 24-hours after each infusion, researchers evaluated patients using the Montgomery-Asberg Depression Rating Scale (MADRS), the MADRS suicidal ideation item and the PTSD symptom Checklist for DSM-5 (PCL-5) subscales for intrusion, avoidance, negative changes in cognition and mood, and arousal and reactivity alterations as well as a visual analog scale of pain.
Albott and colleagues observed significant improvement in suicidal ideation among veterans with PTSD and MDD 24 hours after the first infusion (z = 3.21; P = .001), which remained at all other post-infusion time points.
In addition, at last infusion, improvement in suicidal ideation was associated with PTSD subscales of avoidance (r(12) = 0.61; P = .021), negative alteration in cognition and mood (r(12) = 0.786; P = .001) and alterations in arousal and reactivity (r(12) = 0.729; P = .003), as well as pain (r(12) = 0.591; P = .013) independent of improvement in depressive symptoms. – by Savannah Demko
Albott CS, et al. Improvement in suicidal ideation after repeated ketamine infusions: Relationship to reductions in symptoms of posttraumatic stress disorder, depression, and pain. Presented at: The Anxiety and Depression Association of America Annual Conference; Mar. 28-31, 2019; Chicago.
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