Archival ReportSynaptic Potentiation Is Critical for Rapid Antidepressant Response to Ketamine in Treatment-Resistant Major Depression
Section snippets
Patients
All patients were studied at the National Institute of Mental Health in Bethesda, Maryland, between January 2007 and December 2009. Twenty right-handed patients (5 women, 46 ± 14 years of age) with a DSM-IV diagnosis of MDD (30) without psychotic features met the following inclusion criteria: current major depressive episode of at least 4-week duration, current or past history of lack of response to two adequate antidepressant trials (19 of 20 patients met this criterion for the current
Symptomatic Change
Paired t tests (Bonferroni-corrected) were conducted to assess symptom change at each time point after ketamine, relative to baseline scores taken 60 min before the infusion. One patient was missing a MADRS score at 40 min, a BPRS-pos score at 40 min and 80 min, and a CADSS score at 80 min. A second patient was missing a CADSS score at 40 min. The MADRS scores were significantly reduced at all time points (all t values > 4.7, p values < .001) (Figure 2A). Nine patients reached a response
Discussion
Here we investigated cortical changes associated with ketamine administration in the context of treatment response in treatment-resistant MDD patients. Stimulus-evoked responses and spontaneous SS ctx activity were measured with MEG before and after a single infusion of ketamine to extend our previous work that focused exclusively on pretreatment brain-based predictors of treatment response (43, 49, 50). For those patients exhibiting a rapid and robust reduction in depressive symptoms
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