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An assessment of the anti-fatigue effects of ketamine from a double-blind, placebo-controlled, crossover study in bipolar disorder.

التفاصيل البيبلوغرافية
العنوان: An assessment of the anti-fatigue effects of ketamine from a double-blind, placebo-controlled, crossover study in bipolar disorder.
المؤلفون: Saligan LN; National Institute of Nursing Research, Division of Intramural Research, National Institutes of Health, 31 Center Drive, MSC 2178, Bethesda, MD 209892, USA. Electronic address: saliganl@mail.nih.gov., Luckenbaugh DA; Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, 10 Center Drive, Rm 4N222, MSC 1381 Bethesda, MD 20892, USA. Electronic address: luckenbd@mail.nih.gov., Slonena EE; Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, 10 Center Drive, Rm 4N222, MSC 1381 Bethesda, MD 20892, USA. Electronic address: elizabeth.slonena@nih.gov., Machado-Vieira R; Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, 10 Center Drive, Rm 4N222, MSC 1381 Bethesda, MD 20892, USA. Electronic address: rodrigo.machadovieira@nih.gov., Zarate CA Jr; Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, 10 Center Drive, Rm 4N222, MSC 1381 Bethesda, MD 20892, USA. Electronic address: zaratec@mail.nih.gov.
المصدر: Journal of affective disorders [J Affect Disord] 2016 Apr; Vol. 194, pp. 115-9. Date of Electronic Publication: 2016 Jan 19.
نوع المنشور: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
مواضيع طبية MeSH: Bipolar Disorder/*drug therapy , Depressive Disorder, Treatment-Resistant/*drug therapy , Fatigue/*prevention & control , Ketamine/*therapeutic use, Adult ; Cross-Over Studies ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors ; Retrospective Studies ; Treatment Outcome
مستخلص: Background: Fatigue is a multidimensional condition that is difficult to treat with standard monoaminergic antidepressants. Ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist produces rapid and robust improvements in depressive symptoms in treatment-resistant depression. However, there is a dearth of literature examining the anti-fatigue effects of ketamine. We hypothesize that ketamine will rapidly improve fatigue symptoms in treatment-resistant depressed patients.
Methods: This is an exploratory analysis of data obtained from two double-blind, randomized, placebo-controlled, crossover trials. A total of 36 participants with treatment-resistant bipolar I or II disorder in a depressive episode (maintained on therapeutic levels of lithium or valproate) received a single infusion of ketamine hydrochloride intravenously (0.5 mg/kg over 40 min) or placebo. A post-hoc analysis compared fatigue scores on ketamine vs. placebo at 10 time points from baseline through 14 days post-treatment using the National Institute of Health-Brief Fatigue Inventory.
Results: A linear mixed model showed that ketamine significantly lowered fatigue scores compared to placebo from 40 min post-treatment to Day 14 with the exception of Day 7. The largest difference in anti-fatigue effects between placebo and ketamine was at day 2 (d=0.58, p<0.05). The effect remained significant after controlling for changes in non-fatigue depressive symptoms.
Limitation: The retrospective nature and a small sample size are study limitations.
Conclusions: Ketamine rapidly improved fatigue relative to placebo in a group of individuals with treatment-resistant bipolar depression. NMDAR is a glutamate receptor; hence, glutamate may represent a valuable target to study the clinical efficacy of new anti-fatigue approaches in multiple disorders.
(Published by Elsevier B.V.)
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معلومات مُعتمدة: Z99 NR999999 United States Intramural NIH HHS
فهرسة مساهمة: Keywords: Depression; Fatigue; Glutamate; Ketamine; New therapeutics
المشرفين على المادة: 0 (Receptors, N-Methyl-D-Aspartate)
690G0D6V8H (Ketamine)
تواريخ الأحداث: Date Created: 20160126 Date Completed: 20161006 Latest Revision: 20220330
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC4769920
DOI: 10.1016/j.jad.2016.01.009
PMID: 26807672
قاعدة البيانات: MEDLINE
الوصف
تدمد:1573-2517
DOI:10.1016/j.jad.2016.01.009