Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study

Q3 Psychology

Journal of Affective Disorders Reports Pub Date : 2025-01-01 DOI:10.1016/j.jadr.2024.100870

Naima Guhad Shire , Michael Ioannou , Örjan Falk , Ane Bakken Wold , Caroline Wass , Zoltán Szabó , Steinn Steingrimsson

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引用次数: 0

Abstract

Background

Ketamine shows promise for treating bipolar depression, particularly in severe cases. However, the optimal administration route and enantiomer (esketamine, arketamine, or racemic mixture) remain unclear. This case series presents data on intravenous (IV) esketamine in bipolar depression, addressing a gap in published literature.

Methods

This retrospective chart review included adult inpatients with bipolar depression treated with multiple IV esketamine infusions. Outcomes were measured using the self-rated Montgomery Åsberg Depression Scale (MADRS-S) and clinician-rated improved Global Clinical Impression Scale-Severity Index (rCGI-S). Tolerability data were also collected.

Results

Thirteen patients received 4–6 IV esketamine infusions over two weeks. Statistically significant improvements were observed in MADRS-S total scores (p = 0.002) and rCGI-S scores (p < 0.001) but not in MADRS-S suicidal thoughts item (p = 0.125). Infusions were generally well-tolerated, with treatment-emergent hypomania in two patients (15.4 %).

Limitations

The retrospective design without a control group limited effectiveness evaluation.

Conclusions

Preliminary results of IV esketamine for bipolar depression are promising, but its role in treatment algorithms requires clarification. Randomized controlled studies are needed to investigate its effectiveness further.

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双相抑郁症住院患者反复静脉输注艾氯胺酮：一项回顾性现实世界研究

背景氯胺酮显示出治疗双相抑郁症的希望，特别是在严重的病例中。然而，最佳给药途径和对映体（艾氯胺酮、阿氯胺酮或外消旋混合物）仍不清楚。本病例系列介绍了静脉注射（IV）艾氯胺酮治疗双相抑郁症的数据，解决了已发表文献中的空白。方法回顾性分析多次静脉注射艾氯胺酮治疗的成年双相抑郁症患者。结果采用自评Montgomery Åsberg抑郁量表（MADRS-S）和临床评定改良的全球临床印象量表-严重程度指数（rCGI-S）进行测量。还收集了耐受性数据。结果13例患者在2周内静脉滴注艾氯胺酮4 ~ 6次。MADRS-S总分（p = 0.002）和rCGI-S评分(p <；0.001)，但在MADRS-S自杀念头项中无差异（p = 0.125）。输注总体耐受良好，2例患者（15.4%）出现治疗后出现的轻度躁狂。局限性：没有对照组的回顾性设计限制了有效性评估。结论静脉注射艾氯胺酮治疗双相抑郁症的初步结果是有希望的，但其在治疗算法中的作用有待明确。需要随机对照研究进一步调查其有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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