Residual Depressive Symptoms in Treatment-Resistant Bipolar Depression Following Short-Term Ketamine Administration.

IF 1.9 Q3 PHARMACOLOGY & PHARMACY
Michał Pastuszak, Wiesław Jerzy Cubała, Aleksander Kwaśny
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引用次数: 0

Abstract

Background: Residual symptoms are frequently observed in a significant number of patients with depression, indicating an unmet need for effective management strategies to achieve functional recovery.

Objective: This observational study aimed to evaluate the impact of ketamine infusions on depressive symptoms in patients with bipolar disorder who continued their baseline psychotropic and chronic somatic treatments.

Methods: Datasets of the two consecutive real-world registries (NCT04226963 for 2019-2022; NCT05565352 from 2023 onward) for the tertiary reference center for psychiatry at the Medical University of Gdańsk (Poland) for the safety and tolerability of ketamine use in mood and anxiety disorders were retrospectively analyzed. Depressive symptoms were assessed using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Residual symptoms were identified in patients who achieved a treatment response, defined as a 50% or greater reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to the seventh infusion.

Results: Overall, 14 out of 22 patients met the criteria for response. The most commonly persistent depressive symptoms included sad mood (85.7%), view of my future (78.6%), difficulty falling asleep, and leaden paralysis/physical energy (both 71.4%), with the most severe being difficulty falling asleep (64.3%) and sad mood (42.9%).

Conclusions: This observational post hoc analysis indicates that the most frequently observed residual depressive symptoms were low mood, altered view of future, sleep disturbances, and low energy levels. This study should be treated with caution as causality does not apply, however, it reports on a real-world population of subjects with treatment-resistant bipolar depression. Establishing standardized definitions for residual symptoms could enhance the quality and comparability of future research in this area.

短期服用氯胺酮后,治疗耐受性躁郁症患者的抑郁症状残留。
背景:相当多的抑郁症患者经常出现残留症状,这表明他们对有效的管理策略仍有需求,以实现功能康复:大量抑郁症患者经常出现残留症状,这表明他们对实现功能康复的有效管理策略的需求尚未得到满足:本观察性研究旨在评估氯胺酮输注对继续接受基线精神药物和慢性躯体治疗的双相情感障碍患者抑郁症状的影响:对格但斯克医科大学(波兰)精神病学三级参考中心的两个连续真实世界登记数据集(2019-2022年为NCT04226963;2023年起为NCT05565352)进行了回顾性分析,以了解氯胺酮用于情绪和焦虑障碍的安全性和耐受性。抑郁症状采用抑郁症状自我报告30量表(IDS-SR30)进行评估。在获得治疗反应的患者中确定了残留症状,治疗反应的定义是蒙哥马利-阿斯伯格抑郁量表(MADRS)评分从基线到第七次输液时减少 50%或更多:总的来说,22 位患者中有 14 位符合治疗反应标准。最常见的持续性抑郁症状包括悲伤情绪(85.7%)、对未来的看法(78.6%)、入睡困难和铅质麻痹/体力不支(均为 71.4%),其中最严重的是入睡困难(64.3%)和悲伤情绪(42.9%):这项观察性事后分析表明,最常观察到的残余抑郁症状是情绪低落、对未来的看法改变、睡眠障碍和精力不足。然而,这项研究报告的对象是现实世界中患有难治性双相抑郁症的人群,因此应谨慎对待这项研究,因为其中并不存在因果关系。为残余症状建立标准化定义可以提高该领域未来研究的质量和可比性。
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来源期刊
Drugs - Real World Outcomes
Drugs - Real World Outcomes PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
5.00%
发文量
49
审稿时长
8 weeks
期刊介绍: Drugs - Real World Outcomes targets original research and definitive reviews regarding the use of real-world data to evaluate health outcomes and inform healthcare decision-making on drugs, devices and other interventions in clinical practice. The journal includes, but is not limited to, the following research areas: Using registries/databases/health records and other non-selected observational datasets to investigate: drug use and treatment outcomes prescription patterns drug safety signals adherence to treatment guidelines benefit : risk profiles comparative effectiveness economic analyses including cost-of-illness Data-driven research methodologies, including the capture, curation, search, sharing, analysis and interpretation of ‘big data’ Techniques and approaches to optimise real-world modelling.
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