Adolescents treated with intravenous ketamine for treatment-resistant depression showed a significant average decrease— 42.5%—in Children’s Depression Rating Scale scores, according to a small, open-label study published online in the Journal of Child and Adolescent Psychopharmacology.
“Novel interventions for treatment-resistant depression (TRD) in adolescents are urgently needed,” wrote researchers. “Ketamine has been studied in adults with TRD, but little information is available for adolescents.”
Researchers investigated the efficacy and tolerability of intravenous ketamine in 13 adolescents whose depression failed to improve with 2 previous antidepressant attempts. Patients received 6 ketamine infusions, dosed at 0.5 mg/kg, over 2 weeks.
In addition to an average depression rating scale score drop of 42.5%, 5 study participants met criteria for clinical response, defined as a 50% drop in rating scale score. At a 6-week follow-up, 3 of the 5 responders showed sustained remission, while the other 2 had experienced relapse.
A higher ketamine dose significantly predicted clinical response to treatment. The infusions were generally well tolerated, researchers reported.
“The preliminary results reported here are promising; but large-scale, double-blind, randomized control designs are needed to determine if ketamine is a safe and effective treatment for adolescent TRD,” researchers wrote. “Important questions remain regarding optimal dose, response prediction (patient selection), and long-term safety following acute treatment.”
Cullen KR, Amatya P, Roback MG, et al. Intravenous ketamine for adolescents with treatment-resistant depression: an open-label study. Journal of Child and Adolescent Psychopharmacology. 2018 July 13;[Epub ahead of print].