The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication
Bibliographic Data
| ID | 15529501 |
|---|---|
| Authors | Veronika Andrashko (0000-0001-5488-3345, National Institute of Mental Health, corresponding author), Tomáš Novák (0000-0001-9156-9654, Charles University), Martin Brunovský (0000-0002-2483-0848, Charles University), Monika Klírová (0000-0002-8092-9586, National Institute of Mental Health), P Šóš (0000-0002-3694-1289, National Institute of Mental Health), Jiřı́horáček (0000-0003-0114-7306, National Institute of Mental Health), Jiří Horáček |
| Year | 2020 |
| Volume | 11 |
| Pages | 844-844 |
| Publication date | 2020-08-28 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Psychiatry (JOURNAL) |
| Journal identifiers | ISSN: 1664-0640 • E-ISSN: 1664-0640 |
| Publisher | Frontiers Media (PUBLISHER • CH) |
| DOI | 10.3389/fpsyt.2020.00844 |
| PMID | 33005153 |
| OpenAlex | W3082674901 |
| Language | EN |
| Citations received | 5 |
| References cited | 47 |
The rapid antidepressant effect of ketamine has become a breakthrough in the research and treatment of depression. Although predictive and modulating factors of the response to ketamine are broadly studied, little is known about optimal concurrent medication protocols. Concerning gamma-aminobutyric acid neurotransmission being a shared target for both ketamine and benzodiazepines (BZD), we evaluated the influence of BZD on the antidepressant effect of a single ketamine infusion in depressed patients. Data from 47 patients (27 females) with major depression (MADRS ≥ 20, ≥ 1 prior nonresponse to antidepressant treatment in current episode) who participated in two previous studies (EudraCT Number: 2009-010625-39 and 2013-000952-17) entered the analysis. All of the subjects were given an infusion of a subanesthetic dose of racemic ketamine (0.54 mg per kg) as an add-on medication to ongoing antidepressant treatment. Thirteen patients (28%) reached ≥ 50% reduction in MADRS within one week after ketamine administration. Nineteen (40%) patients took concomitant benzodiazepines on a daily basis. The doses of BZDs were significantly higher in nonresponders (p=0.007). ROC analysis distinguished responders from nonresponders by a criterion of >8mg of diazepam equivalent dose (DZ equivalent) with a sensitivity of 80% and a specificity of 85% (p 8mg of DZ equivalent) and BZD- (≤8mg of DZ equivalent) groups, with a significantly worse outcome in BZD+ on day 3 (p=0.04) and day 7 (p=0.02). The results of the study indicate that concomitant benzodiazepine treatment in higher doses may attenuate ketamine's antidepressant effect. The pathophysiological, clinical and methodological implications of this finding should be considered in future research and ketamine treatment
Anesthesia · Antidepressant · Anxiety · Benzodiazepine · Concomitant · Depression (economics · Diazepam · Ketamine · Psychiatry · Treatment-resistant depression · Electroconvulsive Therapy Studies · Medicine · Treatment of Major Depression · Tryptophan and brain disorders · Internal Medicine · Pharmacology
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| Unique citing works | 5 |
|---|---|
| Citations per year | 1 |
| Citation span | 2021 - 2024 (4) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 5 |