Real-world depression, anxiety and safety outcomes of intramuscular ketamine treatment: a retrospective descriptive cohort study

BMC Psychiatry

Research

Sachin Ahuja¹  Leo Smart¹  Madeline Brendle²  Claire Moore³  Reid Robison⁴  Paul Thielking⁴ 

[1] Cedar Psychiatry, Springville, UT, USA;Cedar Psychiatry, Springville, UT, USA;Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA;Cedar Psychiatry, Springville, UT, USA;Numinus Wellness, Vancouver, British Columbia, Canada;Cedar Psychiatry, Springville, UT, USA;Numinus Wellness, Vancouver, British Columbia, Canada;University of Utah School of Medicine, 721 E 12200 S, 84020, DraperSalt Lake City, UT, USA;

关键词: Ketamine;    Intramuscular ketamine;    Real-world data;    Depression;    Suicidal ideation;    Anxiety;    Safety;   

DOI  :  10.1186/s12888-022-04268-5

 received in 2022-02-06, accepted in 2022-09-20,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundKetamine has emerged as a promising pharmacotherapy for depression and other mental illnesses, and the intramuscular (IM) administration of ketamine is now offered at many North American outpatient psychiatric clinics. However, a characterization of the outpatient population receiving IM ketamine treatment and an evaluation of the real-world depression, anxiety, and safety outcomes of long-term psychiatric IM ketamine treatment has not been reported. This study aimed to evaluate the clinical characteristics, treatment patterns, clinical outcomes, and adverse events of patients receiving IM ketamine treatment.MethodsPatient data from the electronic health records of a private outpatient psychiatric clinic network in the United States were collected and analyzed retrospectively. Adults with any psychiatric diagnosis who received ketamine treatment only by IM administration from January 2018 to June 2021 were included. A total of 452 patients were included in the cohort.ResultsPatients receiving IM ketamine treatment had a mean of 2.8 (SD 1.4) psychiatric diagnoses. 420 (93%) patients had a diagnosis of major depressive disorder, 243 (54%) patients had a diagnosis of generalized anxiety disorder, and 126 (28%) patients had a diagnosis of post-traumatic stress disorder. Patients received a median of 4 (range 1–48) IM ketamine treatments. Median depression scores (PHQ-9) improved 38% from 16.0 (IQR 11.3–21.8) at baseline to 10.0 (IQR 6.0–15.0) at last treatment (p < .001). Median anxiety scores (GAD-7) improved 50% from 14.0 (IQR 8.0–17.0) at baseline to 7.0 (IQR 4.3–11.8) at last treatment (p < .001). With maintenance ketamine treatments, average improvements in depression (PHQ-9) and anxiety (GAD-7) scores of at least 4.7 and 4.9 points were maintained for over 7 months. An adverse event occurred during 59 of 2532 treatments (2.3%).ConclusionsIM ketamine is being utilized to treat psychiatric outpatients with multiple mental illnesses not limited to depression. Average depression and anxiety levels significantly improve throughout IM ketamine treatment and do not regress to baseline during patients’ maintenance treatment phase. Prospective studies are recommended to confirm the long-term effectiveness and safety of IM ketamine.

【 授权许可】

CC BY   
© The Author(s) 2022. corrected publication 2022

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