1. The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder
- Author
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Roger C.M. Ho, Kevin Kratiuk, Roger S. McIntyre, Rodrigo B. Mansur, Orly Lipsitz, Flora Nasri, Mehala Subramaniapillai, Joshua D. Rosenblat, Kangguang Lin, Andrea Fagiolini, Gin S Malhi, Yena Lee, Nelson B. Rodrigues, Hartej Gill, Maj Vinberg, Trisha Suppes, and Danielle S. Cha
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bipolar Disorder ,Anxiety ,Irritability ,bipolar depression ,intravenous ketamine ,NMDA ,suicidal ideation ,treatment-resistant depression ,Suicidal Ideation ,03 medical and health sciences ,Depressive Disorder, Treatment-Resistant ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Ketamine ,Bipolar disorder ,Suicidal ideation ,Biological Psychiatry ,Psychomotor Agitation ,Retrospective Studies ,Depressive Disorder, Major ,business.industry ,Middle Aged ,medicine.disease ,Irritable Mood ,030227 psychiatry ,Psychiatry and Mental health ,Mood disorders ,Major depressive disorder ,Female ,Self Report ,medicine.symptom ,business ,Treatment-resistant depression ,030217 neurology & neurosurgery ,medicine.drug - Abstract
OBJECTIVE To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD). METHOD Adults (N = 201) with treatment-resistant MDD or BD received repeat-dose IV ketamine treatment at a community-based clinic. Mixed features were measured using symptoms of anxiety, irritability, and agitation (AIA), as measured by the Generalized Anxiety Disorder-7 (GAD-7) scale. The Quick Inventory for Depressive Symptomatology Self-Report-16 (QIDS-SR16 ) was used to measure overall treatment response, and the QIDS-SR16 suicidal ideation (SI) item was used to measure change in SI symptoms with ketamine treatment. The anxiety, irritability, and agitation items on the GAD-7 were used to assess effectiveness of IV ketamine in treating symptoms of mixed features. RESULTS In this retrospective analysis, 113 participants met AIA criteria. Participants with AIA experienced a significantly greater reduction in overall depressive symptoms (F(1, 558) = 9.49, P = .002), SI (F(1, 558) = 3.103, P = .079), anxiety (F(1, 198) = 5.52, P = .007), irritability (F(1, 198) = 28.35, P
- Published
- 2020