Repeat-Dose Ketamine Augmentation for Treatment-Resistant Depression with Chronic Suicidal Ideation: A Randomized, Double Blind, Placebo Controlled Trial

Major depressive disorder (MDD) is a very common psychiatric disorder, impacting between 7.0 and 12% of men and between 20.0 and 25.0% of women in the general population.(Kessler et al., 2003) Though numerous well-established treatments for MDD exist (e.g., antidepressants, psychotherapy, somatic interventions), approximately 30% of MDD patients remain symptomatic, even after multiple adequate medication trials.(Rush et al., 2009) Risk of hospitalization among such patients with “treatment-resistant depression” (TRD) is at least twice as high, and TRD patients incur significantly higher costs than their non-treatment-resistant, depressed.(Crown et al., 2002) Chronic suicidal ideation (SI) is also common among individuals with TRD, who are more likely to engage in suicid al behavior than treatment responders.(Souery et al., 2007) Patients with TRD and SI are an especially difficult-to-treat group, as patients with SI also tend to respond less well to antidepressants in the short term.(Lopez-Castroman et al., 2016) Unfortunately, given the severity of their illness, high number of failed treatment trials, and elevated suicide risk, individuals with TRD and current, significant SI are often excluded from clinical trials, which has impeded the much-needed development of novel interventions for this high-risk population.
Source: Journal of Affective Disorders - Category: Neurology Authors: Source Type: research