The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023752%3A_____%2F20%3A43920292" target="_blank" >RIV/00023752:_____/20:43920292 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/20:43920425

Result on the web

<a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00844/full" target="_blank" >https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00844/full</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fpsyt.2020.00844" target="_blank" >10.3389/fpsyt.2020.00844</a>

Result language

angličtina

Original language name

The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication

Original language description

The rapid antidepressant effect of ketamine has become a breakthrough in the research and treatment of depression. Although predictive and modulating factors of the response to ketamine are broadly studied, little is known about optimal concurrent medication protocols. Concerning gamma-aminobutyric acid neurotransmission being a shared target for both ketamine and benzodiazepines (BZD), we evaluated the influence of BZD on the antidepressant effect of a single ketamine infusion in depressed patients. Data from 47 patients (27 females) with major depression (MADRS ≥ 20, ≥ 1 prior nonresponse to antidepressant treatment in current episode) who participated in two previous studies (EudraCT Number: 2009-010625-39 and 2013-000952-17) entered the analysis. All of the subjects were given an infusion of a subanesthetic dose of racemic ketamine (0.54 mg per kg) as an add-on medication to ongoing antidepressant treatment. Thirteen patients (28%) reached ≥ 50% reduction in MADRS within one week after ketamine administration. Nineteen (40%) patients took concomitant benzodiazepines on a daily basis. The doses of BZDs were significantly higher in nonresponders (p=0.007). ROC analysis distinguished responders from nonresponders by a criterion of &gt;8mg of diazepam equivalent dose (DZ equivalent) with a sensitivity of 80% and a specificity of 85% (p&lt;0.001). RM-ANOVA revealed a different time pattern of response to ketamine between the BZD+ (&gt;8mg of DZ equivalent) and BZD− (≤8mg of DZ equivalent) groups, with a significantly worse outcome in BZD+ on day 3 (p=0.04) and day 7 (p=0.02). The results of the study indicate that concomitant benzodiazepine treatment in higher doses may attenuate ketamine’s antidepressant effect. The pathophysiological, clinical and methodological implications of this finding should be considered in future research and ketamine treatment.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30215 - Psychiatry

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2020

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Frontiers in Psychiatry

ISSN

1664-0640

e-ISSN

—

Volume of the periodical

11

Issue of the periodical within the volume

August

Country of publishing house

CH - SWITZERLAND

Number of pages

7

Pages from-to

"Article number 844"

UT code for WoS article

000570558700001

EID of the result in the Scopus database

2-s2.0-85090755590