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Racemic Ketamine as...
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Ekstrand, JoakimLund University,Lunds universitet,Enheten för psykiatrisk neuromodulering (PNU),Forskargrupper vid Lunds universitet,Psychiatric Neuromodulation Unit (PNU),Lund University Research Groups,Lund Univ, Sweden
(author)
Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression : A Randomized, Open-Label, Non-Inferiority Trial (KetECT)
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2021-12-04
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Oxford University Press,2022
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-96436
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-96436URI
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https://doi.org/10.1093/ijnp/pyab088DOI
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https://lup.lub.lu.se/record/5106fb3d-8fdc-44eb-9b0b-6567ca84d9e9URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-184969URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding agencies:Königska FoundationLions forsknings foundation SkåneOM Perssons donation foundation
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Funding Agencies|Swedish Research Council [2015-00799]; Crafoord Foundation; Skane Regional Council; Konigska Foundation; Lions forsknings foundation Skane; OM Perssons donation foundation
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BACKGROUND: Ketamine has emerged as a fast-acting and powerful antidepressant, but no head to head trial has been performed, Here, ketamine is compared with electroconvulsive therapy (ECT), the most effective therapy for depression.METHODS: Hospitalized patients with unipolar depression were randomized (1:1) to thrice-weekly racemic ketamine (0.5 mg/kg) infusions or ECT in a parallel, open-label, non-inferiority study. The primary outcome was remission (Montgomery Åsberg Depression Rating Scale score ≤10). Secondary outcomes included adverse events (AEs), time to remission, and relapse. Treatment sessions (maximum of 12) were administered until remission or maximal effect was achieved. Remitters were followed for 12 months after the final treatment session.RESULTS: In total 186 inpatients were included and received treatment. Among patients receiving ECT, 63% remitted compared with 46% receiving ketamine infusions (P = .026; difference 95% CI 2%, 30%). Both ketamine and ECT required a median of 6 treatment sessions to induce remission. Distinct AEs were associated with each treatment. Serious and long-lasting AEs, including cases of persisting amnesia, were more common with ECT, while treatment-emergent AEs led to more dropouts in the ketamine group. Among remitters, 70% and 63%, with 57 and 61 median days in remission, relapsed within 12 months in the ketamine and ECT groups, respectively (P = .52).CONCLUSION: Remission and cumulative symptom reduction following multiple racemic ketamine infusions in severely ill patients (age 18-85 years) in an authentic clinical setting suggest that ketamine, despite being inferior to ECT, can be a safe and valuable tool in treating unipolar depression.
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Fattah, ChristianDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden,Lund Univ, Sweden
(author)
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Persson, MarcusLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Sweden(Swepub:lu)ma4184pe
(author)
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Cheng, TonyLund University,Lunds universitet,Psykiatri,Forskargrupper vid Lunds universitet,Psychiatry,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)to0337ch
(author)
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Nordanskog, Pia,1971-Linköpings universitet,Linköping University,Centrum för social och affektiv neurovetenskap (CSAN),Medicinska fakulteten,Centrum för social och affektiv neurovetenskap,Region Östergötland, Psykiatriska kliniken i Linköping(Swepub:liu)piano33
(author)
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Åkeson, JonasLund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)kir-jak
(author)
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Tingström, AndersLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för psykiatrisk neuromodulering (PNU),Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Psychiatric Neuromodulation Unit (PNU),Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)mpu-ati
(author)
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Lindström, MatsLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Psykiatri,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Psychiatry,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)psyk-ml0
(author)
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Nordenskjöld, Axel,1977-Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Örebro Univ, Sweden(Swepub:oru)alnd
(author)
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Movahed, Rad PouyaLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för psykiatrisk neuromodulering (PNU),Forskargrupper vid Lunds universitet,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Psychiatric Neuromodulation Unit (PNU),Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)kfar-pmo
(author)
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Enheten för psykiatrisk neuromodulering (PNU)Forskargrupper vid Lunds universitet
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In:International Journal of Neuropsychopharmacology: Oxford University Press25:5, s. 339-3491461-14571469-5111
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