No evidence for the effectiveness of IV ketamine for treatment resistant mood disorders in retrospective study

Abstract

Better intervention strategies for patients with treatment-resistant depression are greatly needed. McIntyre and colleagues 1 set out to investigate the effectiveness of intravenous (IV) ketamine through a chart review of 201 such outpatients who all received four IV ketamine infusions over one-to-two weeks. They concluded that IV ketamine was effective in treating anxiety, irritability, agitation (AIA) and suicidal ideation (SI) in adults with treatment-resistant mood disorders and suggested that IV ketamine should be considered a treatment alternative for adults with affective disorders presenting with mixed features in addition to suggesting a need for a randomized trial based on their findings. The authors arrived at their conclusion through their observation that, across the whole sample, the patients' AIA and SI symptoms diminished over the course of treatment. McIntyre et al. 1 also categorized patients as having AIA based on scores of ≥2 on four items on the General Anxiety Disorder-7 scale related to anxiety, irritability and agitation, which they considered as a proxy for mixed features, at baseline, while patients with lower scores were categorized as non-AIA.