EFFECT OF SINGLE DOSE OF KETAMINE IN PATIENTS OF MAJOR DEPRESSIVE DISORDER-A PAKISTANI PERSPECTIVE

Abstract

Objective: To evaluate the effect of a single dose of Ketamine in treatment of severe Major Depressive Disorder MDD in Pakistani patients.

Study Design: Quasi-experimental study.

Place and Duration of Study: The study was conducted at Combined Military Hospital, Gilgit, from Apr 2017 to Mar 2018.

Methodology: Twenty nine subjects for this study had a primary diagnosis of severe Major Depressive disorder with a score of more than 19 on the HAM-D (Hamilton rating scale for depression) scale. These patients were divided into two groups. Group A received injection ketamine IV whereas group B received placebo 0.9% normal saline. Both were reassessed after 24 hours and there HAM-D scores were measured again.

Results: Out of the total 29 patients, response was present in 14 (48.2%) and 15 (51.8%) did not respond to the treatment. Out of 19 patients that were treated with ketamine, 12 (63.1%) showed response to treatment while 7 (36.9%) did not respond. Out of 10 patients that were treated with placebo, 2 (20%) showed response to treatment while 8 (80%) did not respond. The p-value with a confidence interval of 95% was 0.033 showing that the difference in the two treatments was statistically significant.

Conclusion: Ketamine demonstrated rapid antidepressant effects in this study, further supporting N-methyl-Daspartate (NMDA) receptor modulation as a novel mechanism for accelerated improvement in severe forms of depression. However further trials are needed to establish long term effects of the drug.