Change in patient-centered outcomes of psychological well-being, sleep, and suicidality following treatment with intravenous ketamine for late-life treatment-resistant depression

Benjamin Vanderschelden, Marie Anne Gebara, Hanadi Ajam Oughli, Meryl A. Butters, Patrick J. Brown, Nuri B. Farber, Alastair J. Flint, Jordan F. Karp, Helen Lavretsky, Benoit H. Mulsant, Charles F. Reynolds, Steven P. Roose, Eric J. Lenze

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To examine whether psychological well-being, sleep, and suicidality improved with treatment with intravenous (IV) ketamine for late-life treatment-resistant depression (TRD). Methods: This is an analysis of secondary outcomes in an open-label late-life TRD study examining the safety, tolerability, and feasibility of IV ketamine infusions. In the acute phase, participants (N = 25) aged 60 years or older received twice-a-week IV ketamine for 4 weeks. Then, participants with Montgomery-Asberg Depression Rating Scale (MADRS) total score <10 or ≥ 30% reduction from baseline proceeded to the continuation phase, an additional four weeks of once-a-week IV ketamine. The secondary outcomes analyzed here are based on the National Institute of Health Toolbox Psychological Well-Being subscales for Positive Affect and General Life Satisfaction, the Pittsburgh Sleep Quality Index, and the Scale for Suicidal Ideation. Results: Psychological well-being, sleep, and suicidality improved during the acute phase and those improvements were sustained during the continuation phase. Greater improvements in measures of psychological well-being and sleep were seen in participants who had greater improvements in MADRS scores and moved onto the continuation phase. All but one of the few participants with high suicidality at baseline improved; there were no cases of treatment-emergent suicidality. Conclusions: Psychological well-being, sleep, and suicidality improved in participants with late-life TRD who received IV ketamine for 8 weeks. A future larger and longer controlled trial is needed to confirm and extend these findings. Registration: ClinicalTrials.gov identifier: NCT04504175.

Original languageEnglish
Article numbere5964
JournalInternational Journal of Geriatric Psychiatry
Volume38
Issue number7
DOIs
StatePublished - Jul 2023

Keywords

  • Geriatric
  • intravenous ketamine
  • psychological well-being
  • treatment-resistant depression

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