This re-analysis of an open-label study (n=103) investigated the effects of ketamine (35mg/70kg, 6x) on pain, depression, and social function in patients with bipolar or unipolar depressive disorder. The results showed that ketamine treatment significantly improved psychosocial functioning and reduced pain index. Mediation analysis revealed that the severity of depressive symptoms and the affective index of pain partially mediated the association between ketamine treatment and improvements in subjective and objective social functioning.
Abstact of Pain mediates the improvement of social functions of repeated intravenous ketamine in patients with unipolar and bipolar depression
“Objective Previous research has shown that ketamine can improve social functions. In addition, evidence also suggests that ketamine can alleviate pain. Herein, we propose that ketamine-induced improvements in pain and depression are partially mediated by a reduction in pain. We aimed to determine whether improvements in pain-mediated changes in psychological function were associated with ketamine treatment.
Method This trial included unipolar or bipolar patients (n = 103) who received 6 intravenous infusions (0.5 mg/kg) of ketamine over 2 weeks. The severity of current depressive symptoms and social function were evaluated by the Montgomery-Åsberg Depression Scale (MADRS), Self-Rating Depression Scale (SDS) and Global Assessment Function (GAF), respectively, at baseline and on day 13 and day 26. At the same time points, the three dimensions of pain, including the sensory index, affective index and present pain intensity (PPI), were measured by the Simple McGill Pain Scale (SF-MPQ).
Results The mixed model results showed that ketamine plays an important role in improving the psychosocial functioning of patients. There was a significant decrease from baseline to the day 13 and day 26, indicating that the pain index of the patient improved significantly. Mediation analysis showed that for SDS score (coef = −5.171, 95 % CI[−6.317, −4.025]) and GAF score (coef = 1.021, 95 % CI[0.848, 1.194]), the overall effect of ketamine was observable. The overall indirect and direct effects of ketamine on social functioning were significant (SDS: direct: coef = −1949 to −2114; total indirect: from 0.594 to 0.664; GAF: from 0.399 to 0.427; total indirect: coef = 0.593 to 0.664). The MADRS total score and emotional index were important mediators of the association between ketamine treatment and improvements in subjective and objective social functioning.
Conclusion Depressive symptom severity and the affective index of pain partially mediated improvements in social function after six repeated ketamine treatments among patients with bipolar or unipolar depressive disorder.“
Authors: Zitao Wu, Yujing Gan, Nanxi Li, Xiaofeng Lan, Chengyu Wang, Fan Zhang, Haiyan Liu, Weicheng Li, Yanxiang Ye, Zhibo Hu, Yuping Ning & Yanling Zhou
Summary of Pain mediates the improvement of social functions of repeated intravenous ketamine in patients with unipolar and bipolar depression
Depression is one of the most common mental illnesses, and it severely influences objective and subjective psychosocial functioning and reduces the quality of life. Approximately one-third of patients with major depression are treatment resistant to current antidepressants, and patients with bipolar disorder do not respond well to antidepressant medications.
In the past 20 years, ketamine has been shown to significantly affect the treatment of refractory depression. It has also been shown to improve the overall functional outcome of patients with treatment-resistant depression, including subjective and objective psychosocial functioning.
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https://doi.org/10.1016/j.jad.2023.04.122
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Cite this paper (APA)
Wu, Z., Gan, Y., Li, N., Lan, X., Wang, C., Zhang, F., ... & Zhou, Y. (2023). Pain mediates the improvement of social functions of repeated intravenous ketamine in patients with unipolar and bipolar depression. Journal of Affective Disorders.
Study details
Compounds studied
Ketamine
Topics studied
Pain
Bipolar Disorder
Depression
Study characteristics
Open-Label
Re-analysis
Participants
103
Humans
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