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Effects of intravenous ketamine on explicit and implicit measures of suicidality in treatment-resistant depression.


ABSTRACT: Intravenous ketamine has shown rapid antidepressant effects in early trials, making it a potentially attractive candidate for depressed patients at imminent risk of suicide. The Implicit Association Test (IAT), a performance-based measure of association between concepts, may have utility in suicide assessment.Twenty-six patients with treatment-resistant depression were assessed using the suicidality item of the Montgomery-Asberg Depression Rating Scale (MADRS-SI) 2 hours before and 24 hours following a single subanesthetic dose of intravenous ketamine. Ten patients also completed IATs assessing implicit suicidal associations at comparable time points. In a second study, nine patients received thrice-weekly ketamine infusions over a 12-day period.Twenty-four hours after a single infusion, MADRS-SI scores were reduced on average by 2.08 points on a 0 to 6 scale (p < .001; d = 1.37), and 81% of patients received a rating of 0 or 1 postinfusion. Implicit suicidal associations were also reduced following ketamine (p = .003; d = 1.36), with reductions correlated across implicit and explicit measures. MADRS-SI reductions were sustained for 12 days by repeated-dose ketamine (p < .001; d = 2.42).These preliminary findings support the premise that ketamine has rapid beneficial effects on suicidal cognition and warrants further study.

SUBMITTER: Price RB 

PROVIDER: S-EPMC2935847 | biostudies-literature | 2009 Sep

REPOSITORIES: biostudies-literature

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Effects of intravenous ketamine on explicit and implicit measures of suicidality in treatment-resistant depression.

Price Rebecca B RB   Nock Matthew K MK   Charney Dennis S DS   Mathew Sanjay J SJ  

Biological psychiatry 20090709 5


<h4>Background</h4>Intravenous ketamine has shown rapid antidepressant effects in early trials, making it a potentially attractive candidate for depressed patients at imminent risk of suicide. The Implicit Association Test (IAT), a performance-based measure of association between concepts, may have utility in suicide assessment.<h4>Methods</h4>Twenty-six patients with treatment-resistant depression were assessed using the suicidality item of the Montgomery-Asberg Depression Rating Scale (MADRS-S  ...[more]

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