Role of Ketamine in Refractory Depression

Abstract

Context: Refractory depression is seen in at least 10 to 30 percent of the patients suffering from depression. Ketamine is a new and effective option with rapid onset of action. But there are limited studies where IM Ketamine was used for treating refractory depression. Hence, this study is aimed at assessing the efficacy of IM Ketamine in patients with refractory depressionAims: To assess the efficacy of intramuscular Ketamine in adult patients with refractory depression.Settings and Design: This was study carried out at a tertiary care center. A total of 15 consecutive patients with refractory depres-sion were recruited. They were administered IM Ketamine (0.5 mg per kg body weight) and HAM D scores were recorded at baseline, after 4 hrs, 24hrs, 72 hrs, and 1 week.Methods and Material: This was an open-label prospective study. 15 subjects between the ages of 18 and 60 were evaluated to make a diagnosis of refractory depression and were recruited after obtaining informed consent. Following materials were used1. Semi-structured case record form2. Hamilton depression rating scale3. Inj. Ketamine 0.5 mg/kg. Statistical analysis used: Paired T-test and chi-square test were usedResults: Patients started improving with IM Ketamine within 4 hours, peak response attained within 48 hrs and lasted for 72 hrs. HAM D score deteriorated and reached the baseline after 1 week in almost all patients.Conclusions: IM administration of Ketamine is effective in refractory depression. It has a rapid onset of action, similar to the IV route.