Real-world effectiveness of repeated intravenous ketamine infusions for treatment-resistant depression in transitional age youth

This retrospective analysis (n=52) investigates the efficacy of ketamine (35-52mg/70kg; 4x) for treating treatment-resistant depression (TRD) in transitional age youth (TAY; age 18-25), comparing them with matched adults. The study finds significant reductions in depression, anxiety, and suicidal ideation in the TAY group, with effect sizes indicative of clinically meaningful improvements. The benefits and safety outcomes in the TAY group were comparable to the GA group, suggesting ketamine can be equally effective and well-tolerated in younger patients with TRD.

Abstract of Real-world effectiveness of repeated IV ketamine infusions for TRD in transitional age youth

“Background: Ketamine is an emerging treatment for treatment-resistant depression (TRD) associated with rapid and robust improvements in depressive symptoms and suicidality. However, the efficacy and safety of ketamine in transitional age youth (TAY; age 18-25) populations remains understudied.

Methods: In this retrospective analysis, TAY patients (n = 52) receiving ketamine for TRD were matched for sex, primary diagnosis, baseline depression severity, and treatment resistance with a general adult (GA) sample (age 30-60). Patients received four ketamine infusions over 2 weeks (0.5-0.75 mg/kg over 40 min). The primary outcome was the change in Quick Inventory of Depressive Symptomatology Self-Report 16-item (QIDS-SR16) over time. Secondary outcomes were changes in QIDS-SR16 suicidal ideation (SI) item, anxiety (Generalized Anxiety Disorder 7-item (GAD-7)), and adverse effects (ClinicalTrials.gov: NCT04209296).

Results: A significant main effect of infusions on reduction of total QIDS-SR16 (p < 0.001), QIDS-SR16 SI (p < 0.001), and GAD-7 (p < 0.001) scores was observed in the TAY group with moderate effect sizes, indicative of clinically significant improvements in depression, anxiety, and suicidality. There were no significant differences between TAY and GA groups on these measures over time, suggesting comparable improvements in both groups. Safety and tolerability outcomes were comparable between groups with only mild, transient adverse effects observed.

Conclusion: Ketamine was associated with comparable clinical benefits, safety, and tolerability in a TAY sample as compared to a matched GA TRD sample.”

Authors: Noah Chisamore, Kevork Danayan, Nelson B. Rodrigues, Joshua D. Di Vincenzo, Shakila Meshkat, Zoe Doyle, Rodrigo Mansur, Lee Phan, Farhan Fancy, Edmond Chau, Aniqa Tabassum, Kevin Kratiuk, Anil Arekapudi, Roger S. McIntyre & Joshua D. Rosenblat