Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review

Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Med...

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Autores principales: Correia-Melo FS, Argolo FC, Araújo-de-Freitas L, Leal GC, Kapczinski F, Lacerda AL, Quarantini LC
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Publicado: Dove Medical Press 2017
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spelling oai:doaj.org-article:182c230924d1491f9e3b2a53d6cf32152021-12-02T00:48:32ZRapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review1178-2021https://doaj.org/article/182c230924d1491f9e3b2a53d6cf32152017-06-01T00:00:00Zhttps://www.dovepress.com/rapid-infusion-of-esketamine-for-unipolar-and-bipolar-depression-a-ret-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS) was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1%) showed therapeutic response (MADRS reduction ≥50%) within 1 week (7 days) of intervention. Remission (MADRS <7) was observed in 10 patients (37.0%) in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3%) and 11 (40.7%) patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during the esketamine infusion was dissociative symptoms ranging from mild to severe, which was reported by 11.1% of patients as a very disturbing experience.Limitations: This study was done retrospectively, had a small sample size, and there was no comparative group.Conclusion: The present study demonstrates that rapid infusion of esketamine is possibly not the optimal choice to administer this drug for treatment-resistant depression due to tolerability reasons. Further controlled studies are required to investigate efficacy, safety, and tolerability profiles among the different types of ketamines and methods of using this drug in depressed patients. Keywords: tolerability, S-(+)-ketamine, treatment-resistant depression, dissociative symptoms, efficacy, safetyCorreia-Melo FSArgolo FCAraújo-de-Freitas LLeal GCKapczinski FLacerda ALQuarantini LCDove Medical PressarticleesketamineS-(+)-ketaminetreatment-resistant depressiondissociative symptomsefficacysafety.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1627-1632 (2017)
institution DOAJ
collection DOAJ
language EN
topic esketamine
S-(+)-ketamine
treatment-resistant depression
dissociative symptoms
efficacy
safety.
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle esketamine
S-(+)-ketamine
treatment-resistant depression
dissociative symptoms
efficacy
safety.
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Correia-Melo FS
Argolo FC
Araújo-de-Freitas L
Leal GC
Kapczinski F
Lacerda AL
Quarantini LC
Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
description Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS) was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1%) showed therapeutic response (MADRS reduction ≥50%) within 1 week (7 days) of intervention. Remission (MADRS <7) was observed in 10 patients (37.0%) in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3%) and 11 (40.7%) patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during the esketamine infusion was dissociative symptoms ranging from mild to severe, which was reported by 11.1% of patients as a very disturbing experience.Limitations: This study was done retrospectively, had a small sample size, and there was no comparative group.Conclusion: The present study demonstrates that rapid infusion of esketamine is possibly not the optimal choice to administer this drug for treatment-resistant depression due to tolerability reasons. Further controlled studies are required to investigate efficacy, safety, and tolerability profiles among the different types of ketamines and methods of using this drug in depressed patients. Keywords: tolerability, S-(+)-ketamine, treatment-resistant depression, dissociative symptoms, efficacy, safety
format article
author Correia-Melo FS
Argolo FC
Araújo-de-Freitas L
Leal GC
Kapczinski F
Lacerda AL
Quarantini LC
author_facet Correia-Melo FS
Argolo FC
Araújo-de-Freitas L
Leal GC
Kapczinski F
Lacerda AL
Quarantini LC
author_sort Correia-Melo FS
title Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
title_short Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
title_full Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
title_fullStr Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
title_full_unstemmed Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
title_sort rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/182c230924d1491f9e3b2a53d6cf3215
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