A study by researchers has found that patients with treatment-resistant depressive symptoms can benefit a great deal from getting weekly ketamine infusions.

This novel finding shows how a controversial drug can play a significant role in psychiatric care.

The Study

A team of investigators, headed by Jennifer L. Phillips, Ph.D., from The Royal’s Institute of Mental Health Research’s Mood Disorders Research Unit, conducted a double-blind, randomized, crossover comparison of single ketamine infusion and active placebo-controlled midazolam.

The study observed patients receiving 6 ketamine infusions thrice weekly over twice weekly infusions once they had a relapse.

Patients who had about 50% in MADRS (Montgomery-Åsberg Depression Rating Scale) received additional 4 infusions once weekly during the maintenance phase.

People who had single ketamine infusion had significantly reduced symptoms after 24 hours versus people treated with midazolam.

The ketamine infusion therapy showed repeated infusion helped a person to have cumulative antidepressant effects and enhancement of antidepressant response rate.

According to investigators, repeated infusions resulted in about 59% of the patients meeting the response criteria, with 3 infusions being the median.

The important findings came just a month after the US FDA approved the use of Spravato (esketamine nasal spray) in 2019 for the treatment of treatment-resistant depression.

The Other Side

Few investigators believe that ketamine might not reach the level of at-home therapy use mainly due to its potential for abuse and use as a prominent street drug.

They also anticipate that the treatment will be costly and an be useful for only a minuscule portion of the depression patient population.

According to them, the only significant benefit that this patient population can get from the ketamine infusion is buying more time for the different treatments they are presently undergoing – be it device-based or pharmacotherapy, or psychotherapies.

These therapies tend to work slowly, and using ketamine helps in covering the gap.

Bottom Line

Whatever the marketed use of ketamine entails, the team of investigators led by Dr. Phillips concludes that people do indeed positively benefit (initial and repeated) from a once-weekly ketamine infusion.

According to Dr. Phillips and her team, these findings do provide new data set that can be useful in determining efficacious administration strategies for the administration of ketamine in treatment-resistant depressive patients.

The investigators also believe that future studies are needed for further expansion of these strategies that will translate into better use of ketamine in clinical settings.