Efficacy of Ketamine with and without Lamotrigine in Treatment-Resistant Depression: A Preliminary Report

被引:5
作者
Joseph, Boney [1 ,2 ]
Nunez, Nicolas A. [1 ]
Kung, Simon [1 ]
Voort, Jennifer L. Vande [1 ]
Pazdernik, Vanessa K. [3 ]
Schak, Kathryn M. [1 ]
Boehm, Stacey M. [1 ]
Carpenter, Brooke [1 ]
Johnson, Emily K. [1 ]
Malyshev, Grigoriy [1 ]
Smits, Nathan [1 ]
Adewunmi, Daniel O. [1 ]
Brown, Sarah K. [1 ]
Singh, Balwinder [1 ]
机构
[1] Mayo Clin, Dept Psychiat & Psychol, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Neurol, Rochester, MN 55905 USA
[3] Mayo Clin, Dept Quantitat Hlth Sci, Rochester, MN 55905 USA
关键词
lamotrigine; ketamine; esketamine; treatment-resistant depression; INTRAVENOUS KETAMINE; ATTENUATION; MECHANISMS; INFUSIONS; GLUTAMATE;
D O I
10.3390/ph16081164
中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
Intravenous (IV) ketamine and FDA-approved intranasal (IN) esketamine are increasingly used for treatment-resistant depression (TRD). Preliminary studies have suggested a synergistic effect of ketamine and lamotrigine, although the data are inconclusive. Herein, we report the response to serial ketamine/esketamine treatment among patients with TRD with or without lamotrigine therapy. In this historical cohort study, we included adult patients with TRD who received serial IV racemic ketamine (0.5 mg/kg over 40-100 min) or IN esketamine (56/84 mg) treatments. A change in depressive symptoms was assessed using the 16-item Quick Inventory of Depressive Symptomatology self-report (QIDS-SR) scale. There were no significant differences in response or remission rates among the patients on or not on lamotrigine during the ketamine/esketamine treatments. For a percent change in the QIDS-SR from baseline, no interaction was found between the lamotrigine groups and treatment number (p = 0.70), nor the overall effect of the group (p = 0.38). There was a trend towards lower dissociation (based on the CADSS score) among current lamotrigine users, especially in patients who received IV ketamine. A major limitation is the limited number of patients taking lamotrigine (n = 13). This preliminary study provides insufficient evidence that continuing lamotrigine therapy attenuates the antidepressant effect of repeated ketamine/esketamine; however, there seems to be a signal toward attenuating dissociation with lamotrigine in patients receiving serial ketamine treatments. Further observational studies or randomized controlled trials are needed to replicate these findings.
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页数:16
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