The Effects Of Intravenous Injection Of Subanesthesia Dose Ketamine On Depression Symptom Of Depression Patients Receiving Traditional Antidepression Therapy

Objective:Existing therapies for major depression have a lag of onset of action of more than one week to produce a therapeutic response; resulting in high risk of suicidal behavior especially in the first 10 days after starting antidepressant treatment. Pharmacological strategies that have rapid onset of antidepressant effects and that are sustained would therefore have an enormous impact on patient care. Recent animal studies demonstrate that ketamine produces a rapid, robust and relatively sustained antidepressant response. The present study aimed to investigate whether ketamine can quickly and obviously improve the therapeutic response of depression patients receiving conventional antidepressant therapy. Methods:Using a randomized, double-blind design,30 depression patients(HDRS≥15 scores, first treatment and refusing MECT therapy) were randomly assigned to ketamine group and control group (n=15 each group), and received intravenous injection of ketamine (0.5mg/kg) or saline(same volume) respectively. All patients received continuously conventional antidepressant therapy after ketamine or saline treatment. All patients's HDRS were judged before and 8 hours, 1,2,3,7 day after intravenous injection of saline solution or ketamine, and adverse reactions were observed during intravenous injection of ketamine or saline. Clinical response was defined as a 50% or greater decrease in the HDRS score from baseline and clinical remission was defined as an HDRS score of 7 or lower. Results HDRS before treatment has no difference (P>0.05), HDRS at each time point after treatment decreased in the two groups to a certain extent, but HDRS in ketamine group was obviously lower than that in saline group (P<0.05).The percent rate of clinical response patients in saline group was 0%,6.6%,20%,20%,46.7% at 8 hours,1,2,3,7 day after treatment respectively, the number of clinical remission patients was only 3 at 7 day after treatment; However the percent rate of clinical response patients in ketamine group was 33.5%,66.6%,46.7%,73.3% and 80% at each time point after treatment respectively, the number of clinical remission patients was 3 at 3 day after treatment. The percent rate of clinical response patients at each point time in ketamine group was obviously higher than that in saline group(P<0.05). There were no severe adverse effects during treatment in the two groups. Conclusion:ketamine therapy can quickly and obvoiusly improve the clinical response of depression patients receiving conventional antidepressant treatment.