Supplementary Material for: Cognitive Behavior Therapy May Sustain Antidepressant Effects of Intravenous Ketamine in Treatment-Resistant Depression
Wilkinson S.T.
Wright D.
Fasula M.K.
Fenton L.
Griepp M.
Ostroff R.B.
Sanacora G.
10.6084/m9.figshare.4990574.v1
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Cognitive_Behavior_Therapy_May_Sustain_Antidepressant_Effects_of_Intravenous_Ketamine_in_Treatment-Resistant_Depression/4990574
<p><b><i>Introduction:</i></b> Ketamine has shown rapid though
short-lived antidepressant effects. The possibility of concerning
neurobiological changes following repeated exposure to the drug
motivates the development of strategies that obviate or minimize the
need for longer-term treatment with ketamine. In this open-label trial,
we investigated whether cognitive behavioral therapy (CBT) can sustain
or extend ketamine's antidepressant effects. <b><i>Methods:</i></b>
Patients who were pursuing ketamine infusion therapy for
treatment-resistant depression were invited to participate in the study.
If enrolled, the subjects initiated a 12-session, 10-week course of CBT
concurrently with a short 4-treatment, 2-week course of intravenous
ketamine (0.5 mg/kg infused over 40 min) provided under a standardized
clinical protocol. <b><i>Results:</i></b> Sixteen participants initiated
the protocol, with 8 (50%) attaining a response to the ketamine and 7
(43.8%) achieving remission during the first 2 weeks of protocol. Among
ketamine responders, the relapse rate at the end of the CBT course (8
weeks following the last ketamine exposure) was 25% (2/8). On
longer-term follow-up, 5 of 8 subjects eventually relapsed, the median
time to relapse being 12 weeks following ketamine exposure. Among
ketamine remitters, 3 of 7 retained remission until at least 4 weeks
following the last ketamine exposure, with 2 retaining remission through
8 weeks following ketamine exposure. Ketamine nonresponders did not
appear to benefit from CBT. <b><i>Conclusions:</i></b> CBT may sustain
the antidepressant effects of ketamine in treatment-resistant
depression. Well-powered randomized controlled trials are warranted to
further investigate this treatment combination as a way to sustain
ketamine's antidepressant effects.</p>
2017-05-10 11:36:02
Cognitive behavior therapy
Major depressive disorder
Relapse
Treatment-resistant depression
Cognition
Ketamine