Abstract
Objective To evaluate the antidepressant effect of ketamine and explore the relationship with the inflammatory factors. Method In a randomized controlled trial, 32 patients with depression were randomized to receive 0.5 mg/kg of ketamine by intravenous infusion via pump in 40 minute duration(16 patients) and normal saline via intravenous infusion (16 patients) as control. The Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Depression Scale- 17 Items (HAMD17) and Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were administered at timepoints of 60 minutes prior to infusion, 110 and 230 minutes, 1, 3 and 7 days after infusion. Response was defined as HAMD17 scores reduced by 50%. Remission was defined as overall HAMD17 scores of ≤ 7. The venous blood sample was collected every hour from all patients. The serum interleukin-1β (IL-1β) and interleukin-6 (IL-6) was measured by radioimmunoassay, and tryptophan (TRP) and cynurin (KYN) assayed by high efficiency liquid chromatography (HPLC). The activity of indolamine 2,3-dioxygenase (IDO) was evaluated by KYN/TRP. Results (1) MADRS (F = 41.013,P 0.05). In patients without response to ketamine, infusion of ketamine had no significant effect on serum levels of IL-1β, IL-6 and KYN/TRP (P>0.05). Conclusion Ketamine treatment is associated rapid improvement in depressive symptoms and remission of suicide ideation. Depressive patients with baseline higher levels of serum IL-1β,IL-6 KYN/TRP ratio may be more sensitive to ketamine treatment. Key words: Ketamine; Depressive disorder; Interleukin-1beta; Interleukins; Indoleamine-pyrrole 2,3,-dioxygenase; Inflammatory factors
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