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Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 World+J+Biol+Psychiatry 2016 ; 17 (3): 230-8 Nephropedia Template TP
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Ninety-six hour ketamine infusion with co-administered clonidine for treatment-resistant depression: a pilot randomized controlled trial #MMPMID26919405
World J Biol Psychiatry 2016[Apr]; 17 (3): 230-8 PMID26919405show ga
Objectives: We examined the feasibility of a high-dose, 96-hour infusion of ketamine in treatment-resistant depression. Methods: Ten participants were randomized to receive a 96-hour ketamine infusion, titrated as tolerated to a target rate of 0.6mg/kg/hour, while 10 received a 40-minute ketamine infusion (0.5mg/kg). Both groups received clonidine, titrated to a maximum of 0.6mg orally daily, during the infusion to mitigate side effects of ketamine. Participants were followed for eight weeks to examine potential antidepressant effects. Results: All 20 participants completed the infusion. Most participants tolerated the infusion well, with minimal psychotomimetic symptoms or blood pressure elevation despite achieving high ketamine concentrations (mean 424ng/ml for 96-hour arm, 156ng/ml for 40-minute arm). There was no rebound hypertension upon discontinuing clonidine. Rapid and sustained improvement in depressive symptoms was observed in both study groups. Higher ketamine concentration was associated with sustained antidepressant response, and was not with greater psychotomimetic side effects, in the 96-hour arm. Conclusions: This study provides evidence for the feasibility of prolonged ketamine infusions in treatment-resistant depression. Co-administration of clonidine appeared to mitigate ketamine's psychotomimetic effects. Further study is required to investigate the extent to which prolonged ketamine infusions could provide both rapid and sustained improvements in treatment-resistant depression.Clinicaltrials.gov identifier NCT01179009