Journal of affective disorders · 2022
The effect of IV ketamine in patients with major depressive disorder and elevated features of borderline personality disorder.
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Chen Kelly S, Dwivedi Yogesh, Shelton Richard C
Аннотация
BACKGROUND: Comorbid borderline personality disorder and major depressive disorder is common and often not adequately responsive to standard antidepressant therapies. Ketamine is a potentially life-saving option.
METHODS: 153 adult patients with MDD were assessed with the Personality Assessment Inventory (PAI) Borderline Subscale. Data was normally distributed with a mean + SD of 38.95 + 11.54. Patients >1 SD above the mean were assigned to the MDD + BF group. All others were assigned to the MDD-BF group. Patients were administered IV ketamine 0.5 mg/kg of ketamine over 40 min. Mood was assessed using the Beck Depression Inventory-II at baseline, 3 and 24 h post-ketamine. Scores between the MDD + BF and MDD-BF group at each time point were compared using t-test or analysis of covariance (ANCOVA) model. The primary outcome was response at 24 h.
RESULTS: The LS mean change in BDI at 24 h was -23.8 (15.3) for MDD + BF and -21.0 (13.5) for MDD-BF (F [1151] = 0.043, p = 0.51). The LS mean change in BDI at 3 h was -21.3 (13.2) for MDD + BF and -19.6 (13.2) for MDD-BF (F[1151] = 0.045, p = 0.83). The LS mean change in BDI at 14 days was -23.2 (15.3) for MDD + BF and -15.3 (15.2) for MDD-BF (F[1130] = 4.24, p = 0.04).
LIMITATIONS: People in the MDD + BF group were not necessarily diagnosable with borderline personality disorder.
CONCLUSIONS: These data indicate that IV ketamine is effective in MDD patients with and without elevated borderline features. This can provide clinicians some reassurance about using ketamine in this population.
METHODS: 153 adult patients with MDD were assessed with the Personality Assessment Inventory (PAI) Borderline Subscale. Data was normally distributed with a mean + SD of 38.95 + 11.54. Patients >1 SD above the mean were assigned to the MDD + BF group. All others were assigned to the MDD-BF group. Patients were administered IV ketamine 0.5 mg/kg of ketamine over 40 min. Mood was assessed using the Beck Depression Inventory-II at baseline, 3 and 24 h post-ketamine. Scores between the MDD + BF and MDD-BF group at each time point were compared using t-test or analysis of covariance (ANCOVA) model. The primary outcome was response at 24 h.
RESULTS: The LS mean change in BDI at 24 h was -23.8 (15.3) for MDD + BF and -21.0 (13.5) for MDD-BF (F [1151] = 0.043, p = 0.51). The LS mean change in BDI at 3 h was -21.3 (13.2) for MDD + BF and -19.6 (13.2) for MDD-BF (F[1151] = 0.045, p = 0.83). The LS mean change in BDI at 14 days was -23.2 (15.3) for MDD + BF and -15.3 (15.2) for MDD-BF (F[1130] = 4.24, p = 0.04).
LIMITATIONS: People in the MDD + BF group were not necessarily diagnosable with borderline personality disorder.
CONCLUSIONS: These data indicate that IV ketamine is effective in MDD patients with and without elevated borderline features. This can provide clinicians some reassurance about using ketamine in this population.