Real-world effectiveness of repeated ketamine infusions for treatment resistant depression during the COVID-19 pandemic

Joshua D Rosenblat; Orly Lipsitz; Joshua D Di Vincenzo; Nelson B Rodrigues; Kevin Kratiuk; Mehala Subramaniapillai; Yena Lee; Anil K Arekapudi; Amir Abrishami; Edmond H Chau; Witold Szpejda; Leslie Wong; Rodrigo B Mansur; Roger S McIntyre

doi:10.1016/j.psychres.2021.114086

Real-world effectiveness of repeated ketamine infusions for treatment resistant depression during the COVID-19 pandemic

Psychiatry Res. 2021 Sep:303:114086. doi: 10.1016/j.psychres.2021.114086. Epub 2021 Jun 29.

Affiliations

¹ Mood Disorder Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
² Mood Disorder Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada.
³ Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Department of Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland.
⁴ Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada.
⁵ Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁶ Mood Disorder Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁷ Mood Disorder Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Canada, University of Toronto, Toronto, ON, Canada. Electronic address: roger.mcintyre@uhn.ca.

Abstract

Herein we evaluate the impact of COVID-19 restrictions on antidepressant effectiveness of intravenous (IV) ketamine in adults with treatment-resistant depression (TRD). We conducted a case series analysis of adults with TRD (n = 267) who received four ketamine infusions at an outpatient clinic in Ontario, Canada, during COVID-19 restrictions (from March 2020 - February 2021; n = 107), compared to patients who received treatment in the previous year (March 2019 - February 2020; n = 160). Both groups experienced significant and comparable improvements in depressive symptoms, suicidal ideation, and anxiety with repeated ketamine infusions. Effectiveness of IV ketamine was not attenuated during the COVID-19 period.

Keywords: Bipolar disorder; COVID-19; Major depression; Psychiatric services; Treatment-resistant depression.

MeSH terms

Adult
COVID-19*
Depression
Depressive Disorder, Major* / drug therapy
Depressive Disorder, Treatment-Resistant* / drug therapy
Humans
Infusions, Intravenous
Ketamine* / therapeutic use
Ontario
Pandemics
SARS-CoV-2

Substances

Ketamine