Ketamine Effective as Maintenance Treatment for Anxiety

April 11, 2018
injection

In patients with treatment-refractory anxiety who responded to ketamine, weekly maintenance doses over 3 months were well tolerated and significantly improved social and work functioning, according to a small study published online in the Journal of Psychopharmacology.

The findings suggest maintenance ketamine may be a therapeutic alternative for that patient population, researchers concluded.

“Their experience of ketamine treatment enabled them to make substantial changes to their lives (for example, employment, study, making friends, engaging socially, and travelling),” a Psychiatric News Alert article quoted from the study. “Reduced anxiety meant everyday tasks were less onerous. Most patients reported an increase in their ability to concentrate, leading to improvement in their functionality.”

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The open-label study involved 20 patients with generalized anxiety disorder and/or social anxiety disorder who responded to ketamine in a previous ascending-dose study. Patients in the maintenance treatment study had 1-2 weekly doses of 1 mg/kg of ketamine injected subcutaneously for 3 months.

Just 1 hour after injection, ratings on both the Fear Questionnaire and the Hamilton Anxiety Rating Scale dropped 50%, researchers reported. Over the course of the study, mean scores on the Clinician Administered Dissociative States Scale decreased, from 20 points at week 1 to 8.8 points at week 14.

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Of the 20 patients enrolled in the study, 18 completed all 3 months of maintenance treatment—and all reported improvements in social and work functioning, Psychiatric News Alert reported. Two weeks after their last ketamine injection, 8 patients experienced some return of anxiety and 5 patients experienced full re-emergence. Three months after maintenance treatment ended, 5 patients remained well.

Nausea, dizziness, and blurred vision were the most common adverse events during the study.

—Jolynn Tumolo

References

Glue P, Neehoff SM, Medlicott NJ, Gray A, Kibby G, McNaughton N. Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalised anxiety and social anxiety disorders. Journal of Psychopharmacology. 2018 March 21;[Epub ahead of print].

Maintenance ketamine may offer alternative for patients with treatment-refractory anxiety disorders. Psychiatric News Alert. March 29, 2018.

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