Examining the impact of comorbid posttraumatic stress disorder on ketamine's real-world effectiveness in treatment-resistant depression

被引：0

作者：

Johnson, Danica E. ^{[1
,2
]}

Rodrigues, Nelson B. ^{[2
,4
]}

Weisz, Sydney ^{[2
]}

Chisamore, Noah ^{[2
,3
]}

Kaczmarek, Erica S. ^{[2
,3
]}

Chen-Li, David C. J. ^{[1
,2
]}

Doyle, Zoe ^{[2
]}

Richardson, J. Don ^{[7
,8
,9
]}

Mansur, Rodrigo B. ^{[1
,2
,6
]}

Mcintyre, Roger S. ^{[1
,2
,3
,5
,6
]}

Rosenblat, Joshua D. ^{[1
,2
,3
,6
]}

机构：

[1] Univ Toronto, Inst Med Sci, Temerty Fac Med, Toronto, ON, Canada

[2] Univ Hlth Network, Toronto Western Hosp, Mood Disorders Psychopharmacol Unit, Toronto, ON, Canada

[3] Univ Toronto, Temerty Fac Med, Dept Pharmacol & Toxicol, Toronto, ON, Canada

[4] Univ Windsor, Dept Psychol, Neuropsychol Track, Windsor, ON, Canada

[5] Brain & Cognit Discovery Fdn, Toronto, ON, Canada

[6] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[7] St Josephs Hlth Care London, St Josephs Operat Stress Injury Clin, London, ON, Canada

[8] St Josephs Hlth Care London, MacDonald Franklin OSI Res & Innovat Ctr, London, ON, Canada

[9] Western Univ, Schulich Sch Med & Dent, Dept Psychiat, London, ON, Canada

来源：

EUROPEAN NEUROPSYCHOPHARMACOLOGY | 2025年 / 91卷

基金：

加拿大健康研究院;

关键词：

Depressive disorder; Treatment-resistant; Ketamine; Stress disorders; Post-traumatic; Comorbidity; Antidepressive agents; 16-ITEM QUICK INVENTORY; PTSD COMORBIDITY; SYMPTOMATOLOGY; PREVALENCE; STRATEGIES; VETERANS; EFFICACY; ADULTS; TRIAL;

D O I：

10.1016/j.euroneuro.2024.11.008

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Depression with comorbid posttraumatic stress disorder (PTSD) is associated with more severe symptoms and a reduced response to traditional treatments. Although ketamine shows promise as a rapid-acting antidepressant for treatment-resistant depression (TRD), its effectiveness in patients with comorbid PTSD remains underexplored. Therefore, we conducted a retrospective analysis of 134 patients from the Canadian Rapid Treatment Center of Excellence to compare the effectiveness of four ketamine infusions (0.5-0.75 mg/kg) in reducing symptoms of depression and PTSD in TRD patients with and without comorbid PTSD. A repeated-measures linear mixed model was used to evaluate the impact of comorbid PTSD on ketamine's antidepressant effectiveness, measured by the Quick Inventory of Depressive Symptomatology Self-Report (QIDSSR16). Paired samples t-tests were used to assess changes in PTSD symptoms, measured by the PTSD Checklist for DSM-5 (PCL-5). We found a significant main effect of time on QIDS-SR16 scores, F(4, 209.32) = 36.67, p <0.001, but no significant group-by-time interaction (p = 0.895), suggesting that comorbid PTSD did not impact the antidepressant effectiveness of ketamine. Significant improvements in PTSD symptoms were observed in overall PCL-5 scores, t(66) = 6.66, p < 0.001, and across all PCL-5 symptom clusters with moderate to large effect sizes. In a real-world sample of TRD patients, ketamine was effective in reducing symptoms of depression and PTSD, regardless of PTSD comorbidity. These findings highlight ketamine's potential as a novel intervention for a patient population that is frequently non-responders to conventional treatments. Future randomized controlled trials should explore mediating factors of improvement and long-term effects.

引用

页码：69 / 77

页数：9