Cognitive Behavior Therapy May Sustain Antidepressant Effects of Intravenous Ketamine in Treatment-Resistant Depression

Summary & key facts

This small open-label study tested whether a 12-session course of cognitive behavioral therapy (CBT) given alongside four intravenous ketamine infusions could help maintain ketamine's antidepressant effects in people with treatment-resistant depression. Sixteen patients started the study; 8 (50%) responded to ketamine and 7 (43.8%) reached remission in the first two weeks. The authors conclude CBT may help sustain ketamine's effects, but they say larger randomized trials are needed to know for sure.

Key facts:

• Study type: an open-label (non-randomized, no control group) trial with 16 participants who were pursuing ketamine for treatment-resistant depression.
• Ketamine treatment: four intravenous infusions over 2 weeks, each dose 0.5 mg/kg infused over 40 minutes, given while patients began a 12-session, 10-week CBT course.
• Response rates in the first 2 weeks: 8 of 16 participants (50%) met response criteria to ketamine; 7 of 16 (43.8%) achieved remission.
• Among the 8 ketamine responders, 2 had relapsed by the end of the CBT course (25% relapse at 8 weeks after the last ketamine infusion).
• Longer-term follow-up among responders: 5 of the 8 eventually relapsed, with a median time to relapse of 12 weeks after the ketamine treatment.
• Among the 7 initial ketamine remitters, 3 remained in remission for at least 4 weeks after the last infusion, and 2 remained in remission through 8 weeks.
• The study found that people who did not respond to ketamine did not appear to benefit from adding CBT.
• Main limitation noted by the authors: the study was small and open-label, so its findings are preliminary and cannot prove that CBT caused longer benefit; the authors call for well-powered randomized controlled trials to test this combinati

Abstract

CBT may sustain the antidepressant effects of ketamine in treatment-resistant depression. Well-powered randomized controlled trials are warranted to further investigate this treatment combination as a way to sustain ketamine's antidepressant effects.

Topics

Mental Health Research Topics Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Anesthesia Antidepressant Clinical trial Cognition Depression (economics) Economics Hippocampus Internal medicine Ketamine Macroeconomics Major depressive disorder Medicine Psychiatry Psychology Randomized controlled trial Treatment-resistant depression