The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder
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The effectiveness of ketamine on anxiety, irritability, and agitation : Implications for treating mixed features in adults with major depressive or bipolar disorder. / McIntyre, Roger S.; Lipsitz, Orly; Rodrigues, Nelson B.; Lee, Yena; Cha, Danielle S.; Vinberg, Maj; Lin, Kangguang; Malhi, Gin S.; Subramaniapillai, Mehala; Kratiuk, Kevin; Fagiolini, Andrea; Gill, Hartej; Nasri, Flora; Mansur, Rodrigo B.; Suppes, Trisha; Ho, Roger; Rosenblat, Joshua D.
I: Bipolar Disorders, Bind 22, Nr. 8, 2020, s. 831-840.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The effectiveness of ketamine on anxiety, irritability, and agitation
T2 - Implications for treating mixed features in adults with major depressive or bipolar disorder
AU - McIntyre, Roger S.
AU - Lipsitz, Orly
AU - Rodrigues, Nelson B.
AU - Lee, Yena
AU - Cha, Danielle S.
AU - Vinberg, Maj
AU - Lin, Kangguang
AU - Malhi, Gin S.
AU - Subramaniapillai, Mehala
AU - Kratiuk, Kevin
AU - Fagiolini, Andrea
AU - Gill, Hartej
AU - Nasri, Flora
AU - Mansur, Rodrigo B.
AU - Suppes, Trisha
AU - Ho, Roger
AU - Rosenblat, Joshua D.
PY - 2020
Y1 - 2020
N2 - 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 <.001), and agitation as measured by “trouble relaxing” (F(1, 198) = 6.70, P =.010) from baseline compared to the non-AIA group, regardless of number of treatments received. Conclusions: Our preliminary results suggest that IV ketamine is effective in rapidly treating AIA and SI in adults with treatment-resistant mood disorders. This observation suggests that IV ketamine could be considered a treatment alternative for adults with MDD or BD presenting with mixed features.
AB - 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 <.001), and agitation as measured by “trouble relaxing” (F(1, 198) = 6.70, P =.010) from baseline compared to the non-AIA group, regardless of number of treatments received. Conclusions: Our preliminary results suggest that IV ketamine is effective in rapidly treating AIA and SI in adults with treatment-resistant mood disorders. This observation suggests that IV ketamine could be considered a treatment alternative for adults with MDD or BD presenting with mixed features.
KW - bipolar depression
KW - intravenous ketamine
KW - NMDA
KW - suicidal ideation
KW - treatment-resistant depression
U2 - 10.1111/bdi.12941
DO - 10.1111/bdi.12941
M3 - Journal article
C2 - 32406161
AN - SCOPUS:85087720394
VL - 22
SP - 831
EP - 840
JO - Bipolar Disorders, Supplement
JF - Bipolar Disorders, Supplement
SN - 1399-2406
IS - 8
ER -
ID: 253145670